Implementation and outcome of thrombolysis with alteplase 3-4·5 h after an acute stroke: an updated analysis from SITS-ISTR

Abstract

Background: In September, 2008, the European Acute Stroke Study III (ECASS III) randomised trial and the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry (SITS-ISTR) observational study reported the efficacy and safety of the extension of the time window for intravenous alteplase treatment from within 3 h to within 4·5 h after stroke onset. We aimed to assess the implementation of the wider time window, its effect on the admission-to-treatment time, and safety and functional outcome in patients recorded in SITS-ISTR. Methods: Patients treated according to the criteria of the European Summary of Product Characteristics, except for the time window, were inc..