I would agree. tPA is not a contraindication to the later prescription of dual antiplatelet therapy. I do not see a definite answer to the question of 21 days versus 90 days, the CHANCE trial (Wang et al., PMID 23803136) supports 21 days and the POINT trial (Johnston et al., PMID 29766750) 90 days. ...

I would recommend dual antiplatelet therapy for 21 days for eligible patients. The risk of recurrence is highest in the first few days and patients will likely still benefit. I would just ensure the patient has no hemorrhage in their 24-hour scan and they would otherwise meet the criteria for the CH...

I would recommend dual antiplatelet therapy for a stroke patient after tPA. I would recommend that it be given for 21 days unless the patient has intracranial vessel narrowing as the cause of the stroke. In that situation, I would recommend dual antiplatelet therapy for 90 days.