Acute management in very old patients: is thrombolysis safe?

In our analysis, patients who were treated with intravenous rt-PA had a better outcome than untreated patients, and this effect was not dependent on age. The weight of evidence to date indicates a potential for benefit in older people, and there is no a priori reason to suspect a diminished effect when compared with younger people. The risk of bleeding is similar in both groups. We believe that clinical treatment guidelines should be revised in order to remove the age restriction in the use of intravenous rt-PA acute ischemic stroke.