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For many years, the conventional time window for administering intravenous thrombolysis (IVT) to patients with acute ischemic stroke has been 0 to 4.5 hours from onset. However, with the increasing adoption of advanced imaging techniques to identify patients with salvageable brain tissue, new trials have been conducted beyond the 4.5-hour time limit.
To synthesize the available evidence, researchers conducted a systematic review and meta-analysis of 14 randomized trials comparing IVT with placebo or standard care at 4.5 hours or more after acute ischemic stroke onset in 4100 adults. Trial participants had generally favorable imaging profiles (Alberta Stroke Program Early CT [ASPECT] Score typically 8–10). The primary study outcomes we…