Alteplase for Acute Ischemic Stroke at 4.5 to 24 Hours

Does intravenous alteplase administered 4.5 to 24 hours after acute ischemic stroke onset improve outcomes in patients with salvageable brain tissue and no initial plan for thrombectomy?In this randomized clinical trial of 372 patients, 40% receiving alteplase achieved functional independence at 90 days vs 26% with standard care, a statistically significant difference.In patients with salvageable brain tissue identified by perfusion imaging who did not initially receive thrombectomy, alteplase given 4.5 to 24 hours after acute ischemic stroke onset may improve functional outcomes.

Corresponding Author: Min Lou, MD, Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, #88 Jiefang Rd, Hangzhou, China (lm99@zju.edu.cn).

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