If thrombolysis with TPA is given, when should aspirin be started?

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Multiple Choice

If thrombolysis with TPA is given, when should aspirin be started?

After thrombolysis with tPA, there’s an important balance between dissolving the clot and avoiding bleeding. tPA breaks down clots but increases the risk of hemorrhage, especially intracranial bleeding. Giving aspirin too soon can amplify that bleeding risk while the vessel is still healing. Waiting about 48 hours allows the fibrinolytic effect to diminish and the brain to stabilize, reducing the chance of a hemorrhagic complication. If there is no bleed on imaging and the patient is neurologically stable, starting low-dose aspirin afterward helps prevent reocclusion and future events. Starting aspirin immediately would raise bleeding risk too early, delaying for too long would miss protection during the high-risk period, and not giving aspirin at all deprives the patient of antiplatelet protection once it’s safe.

After thrombolysis with tPA, there’s an important balance between dissolving the clot and avoiding bleeding. tPA breaks down clots but increases the risk of hemorrhage, especially intracranial bleeding. Giving aspirin too soon can amplify that bleeding risk while the vessel is still healing. Waiting about 48 hours allows the fibrinolytic effect to diminish and the brain to stabilize, reducing the chance of a hemorrhagic complication. If there is no bleed on imaging and the patient is neurologically stable, starting low-dose aspirin afterward helps prevent reocclusion and future events. Starting aspirin immediately would raise bleeding risk too early, delaying for too long would miss protection during the high-risk period, and not giving aspirin at all deprives the patient of antiplatelet protection once it’s safe.

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