Alteplase in an Extended Time Window for Ischemic Stroke

Patients with acute stroke receiving alteplase 4.5 to 24 hours after symptom onset have better outcomes with alteplase than standard treatment, but these study results require confirmation.

The use of intravenous thrombolytic agents such as alteplase or tenecteplase currently has the strongest evidence among patients who present within 4.5 hours of onset of stroke symptoms. Treatment can also be successful for patients with “wake up strokes” who meet certain imaging criteria. Less is known about the use of thrombolytic agents beyond 4.5 hours. To learn more, researchers in China randomized 372 patients who could be treated within 4.5 to 24 hours of symptom onset (median age, 72; National Institutes of Health Stroke Scale median score, 10) to alteplase (0.9 mg/kg; maximum, 90 mg) or usual care.

Patients had to meet imaging criteria on perfusion imaging suggesting salvageable brain tissue, and those with planned thrombectomy were…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Alteplase in an Extended Time Window for Ischemic Stroke

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Reviewing Author