Introduction: The use of low doses of recombinant tissue plasminogen activator (rt-PA) was initially proposed in Asian countries in response to racial peculiarities related to the functionality of fibrinogen and coagulation factors that potentially increased the risk of intracerebral haemorrhage, and with a view to saving costs. In view of the controversy over the use of rt-PA below the standard dose, we conducted a literature review of studies promoting the use of low doses or comparing different doses of rt-PA. Development: We reviewed 198 abstracts related to the search terms and the full texts of 52 studies published in the last 30 years. We finally included 13 randomised clinical trials aiming to determine the efficacy and safety of the use of rt-PA at different doses in acute stroke, 14 observational cohort studies, 5 meta-analyses, and 3 systematic reviews. Conclusions: There is i...

Introduction: The use of low doses of recombinant tissue plasminogen activator (rt-PA) was initially proposed in Asian countries in response to racial peculiarities related to the functionality of fibrinogen and coagulation factors that potentially increased the risk of intracerebral haemorrhage, and with a view to saving costs. In view of the controversy over the use of rt-PA below the standard dose, we conducted a literature review of studies promoting the use of low doses or comparing different doses of rt-PA. Development: We reviewed 198 abstracts related to the search terms and the full texts of 52 studies published in the last 30 years. We finally included 13 randomised clinical trials aiming to determine the efficacy and safety of the use of rt-PA at different doses in acute stroke, 14 observational cohort studies, 5 meta-analyses, and 3 systematic reviews. Conclusions: There is i...

El uso de dosis bajas de activador de plasminógeno tisular recombinante (rt-PA) se propuso inicialmente en países asiáticos en respuesta a peculiaridades raciales relacionadas con la funcionalidad del fibrinógeno y factores de coagulación que potencialmente aumentaban el riesgo de hemorragia intracerebral, y con miras a para ahorrar costos. En vista de la controversia sobre el uso de rt-PA por debajo de la dosis estándar, realizamos una revisión de la literatura de estudios que promueven el uso de dosis bajas o comparan diferentes dosis de rt-PA. Desarrollo: Revisamos 198 resúmenes relacionados con los términos de búsqueda y los textos completos de 52 estudios publicados en los últimos 30 años. Finalmente, incluimos 13 ensayos clínicos aleatorizados con el objetivo de determinar la eficacia y seguridad del uso de rt-PA a diferentes dosis en el ictus agudo, 14 estudios de coh...