Last reviewed 2026-04-22 · How we verify

alteplase dwell arm

Alteplase is a tissue plasminogen activator (tPA) that converts plasminogen to plasmin to dissolve blood clots.

Alteplase is a tissue plasminogen activator (tPA) that converts plasminogen to plasmin to dissolve blood clots. Used for Acute ischemic stroke, Acute myocardial infarction, Pulmonary embolism.

At a glance

Mechanism of action

Alteplase is a recombinant tissue plasminogen activator that directly activates fibrinolysis by converting plasminogen to plasmin, which degrades fibrin in blood clots. The 'dwell arm' formulation refers to a specific administration protocol where the drug dwells in a catheter or treatment area, commonly used in catheter-directed thrombolysis for peripheral arterial or venous occlusions. This localized delivery approach aims to maximize clot dissolution while minimizing systemic exposure.

Approved indications

• Acute ischemic stroke
• Acute myocardial infarction
• Pulmonary embolism
• Peripheral arterial or venous thrombosis (catheter-directed thrombolysis)

Common side effects

• Bleeding (intracranial, gastrointestinal, or other sites)
• Reperfusion arrhythmias
• Hypotension
• Allergic reactions

Key clinical trials

• The Safety and Tolerability of Intra-abdominal t-PA and DNase on Peritonitis in Peritoneal Dialysis Patients (PHASE1)
• Safety and Effectiveness of tPA in Intra-abdominal Abscesses (PHASE2, PHASE3)
• Alteplase for Blood Flow Restoration in Hemodialysis Catheters (PHASE4)

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.