TITLE:
Efficacy of Intravenous Alteplase Thrombolysis in Acute Cerebral Infarction: Anterior vs. Posterior Circulation
AUTHORS:
Jing Huang, Fanrui Zeng
KEYWORDS:
Acute Cerebral Infarction, Alteplase, Intravenous Thrombolysis, Anterior Circulation, Posterior Circulation
JOURNAL NAME:
Health,
Vol.18 No.2,
February
3,
2026
ABSTRACT: Objective: To compare the effects of intravenous alteplase thrombolysis on clinical outcomes and safety between patients with anterior and posterior circulation cerebral infarction. Methods: Between April 2019 and December 2024, 319 patients with acute cerebral infarction underwent intravenous alteplase thrombolysis within 4.5 hours at Zhuhai People’s Hospital. They were divided by infarction site into anterior (n = 219) and posterior (n = 100) circulation groups. Comparisons were made for baseline risk factors, serial National Institute of Health stroke scale (NIHSS) scores, clinical efficacy, discharge mRS scores, and rates of bleeding complications (symptomatic or asymptomatic intracranial hemorrhages, oral/gingival, cutaneous, and gastrointestinal). Results: Baseline Characteristics: The ACS group had a higher proportion of atrial fibrillation, while hypertension and diabetes were more prevalent in the PCS group (both P 0.05). Conclusion: While atrial fibrillation is more common in anterior circulation infarction, hypertension and diabetes are more frequent in posterior circulation infarction. Early alteplase thrombolysis significantly and similarly improves prognosis in both types. For safety, posterior circulation infarction carries a lower risk of intracranial hemorrhage but comparable risks of extracranial bleeding.