ABSTRACT NUMBER: ESOC2026LB138 INTRAVENOUS THROMBOLYSIS IN POST-TRAUMATIC PATIENTS (OFF-LABEL)

Abstract Background and aims There is uncertainty whether intravenous thrombolysis (IVT) can be given in acute ischemic stroke patients with recent history of trauma. Only small case series have been published with diverging results. Moreover, unclear trauma, such as patients found on the floor, has not yet been studied. The aim of this study is to analyse the safety of IVT in patients with acute ischemic stroke and trauma. Methods For this study the IVT registry of the telestroke network TEMPiS was retrospectively screened. During June 2022 and September 2024 consecutive ischemic stroke patients who received IVT and had experienced trauma up to 90 days prior to the stroke were included. Primary outcome is occurrence of bleeding complications in any body part. Analyses include the risk of trauma location, time of occurrence, severity of trauma on any given haemorrhage. Subgroup analyses include patients with head trauma, non-head trauma and trauma of unknown severity/location. The analyses are ongoing. Results Of 1094 patients with IVT recommendation, 134 participants with suspected trauma were included. Median age was 81 years, 54%(73) were female and 46%(61) male. Patient characteristics and bleeding complications are reported descriptively. Comparisons include recent versus non-recent trauma and head trauma versus non-head trauma or trauma of unknown location/severity. Results are presented for the entire collective and stratified according to defined subgroups. Conclusions This is the largest population of acute ischemic stroke patients analysed to receive IVT after trauma. These results have the potential to guide clinicians in patients presenting with this important contraindication. Conflict of interest