MRI-assisted thrombolysis for delayed arrival among patients with ischemic stroke

Time window for thrombolysis in acute ischemic stroke can be based on chronological or physiological (imaging) data. Both of these approaches have their unique strengths and weaknesses. The concept of chronological-based thrombolysis is supported by several randomized clinical trials whereas imaging-based thrombolysis has not been validated entirely by randomized trials. Therefore, careful evaluation of strategies using image-based identification of patients who might benefit from thrombolysis is needed. Patients undergoing thrombolysis on delayed arrival appear to be the most logical group in whom image-based strategies should be evaluated.