Reperfusion after 4·5 hours reduces infarct growth and improves clinical outcomes

Abstract

Background: The currently proven time window for thrombolysis in ischemic stroke is 4·5h. Beyond this, the risks and benefits of thrombolysis are uncertain. Aims: To determine whether thrombolysis and reperfusion were beneficial after 4·5h, we examined clinical and radiological outcomes in patients treated with tissue plasminogen activator or placebo within 4·5-6h, using data from the Echoplanar Imaging Thrombolytic Evaluation Trial. Methods: In the Echoplanar Imaging Thrombolytic Evaluation Trial, ischemic stroke patients presenting three to six-hours after stroke onset were randomized to tissue plasminogen activator or placebo, without knowledge of magnetic resonance imaging results. This ..