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Editor's Pick Original Investigation

Intravenous Thrombolysis Beyond the Conventional Time Window for Acute Ischemic Stroke

JAMA Network Open 10.1001/jamanetworkopen.2026.26990

August 06, 2026 at 11:00 AM EDT

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In this systematic review and meta-analysis of 14 RCTs, IVT administered beyond 4.5 hours after stroke onset was associated with improved functional outcomes despite an increased risk of symptomatic ICH, supporting extension of thrombolytic therapy beyond the conventional treatment window in appropriately imaging-selected patients.

This Original Investigation has an accompanying Editorial.

Corresponding Author: Shaan Patel, MB, BChir, MA, Department of Neurological Surgery, Thomas Jefferson University Hospital, 909 Walnut St, Philadelphia, PA 19107 (shaan.patel@jefferson.edu).

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