Selective Use of Thrombolysis for Acute Stroke Beyond 4.5 Hours

In an observational study, patients treated between 4.5 and 9 hours after onset had similar outcomes to those treated within 4.5 hours.

Intravenous thrombolysis (IVT) usually is administered for eligible patients within 4.5 hours of stroke onset. However, clinical trials have shown that patients can benefit beyond 4.5 hours or with stroke upon awakening. Data are limited regarding the safety and efficacy of IVT beyond 4.5 hours in routine practice. These investigators analyzed outcomes of IVT in the 4.5- to 9-hour time window at 15 European centers. The primary outcomes of interest were symptomatic intracranial hemorrhage (sICH) by ECAS II criteria, poor outcome at 3 months (a score of 4–6 on the modified Rankin scale), and mortality at 3 months. The authors also investigated outcomes according to whether advanced imaging, such as perfusion study, was used in those presenti…

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

Selective Use of Thrombolysis for Acute Stroke Beyond 4.5 Hours

Topics

Reviewing Author