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Updated: Jun 13, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Evolution of the thrombolytic treatment window for acute ischemic stroke
1University of California, San Diego, Medical Office North, Third Floor, Suite 3, 200 West Arbor Drive, #8466, San Diego, CA, 92103, USA. astemer@ucsd.edu
Abstract:
Ischemic stroke is a major cause of morbidity and mortality for which the only approved treatment in the acute setting is intravenous thrombolysis. The efficacy and safety of recombinant tissue plasminogen activator (rt-PA) have been firmly established within 3 h of symptom onset; however, few patients are eligible for treatment in this time window. Expanding the time for treatment has been challenging, but new evidence has demonstrated a modest statistical improvement in selected patients when rt-PA is administered within 4.5 h. This important finding hopefully will enable more patients to receive treatment and simultaneously provides an opportunity to reaffirm that the benefits of rt-PA diminish with time.
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