WSC 2025 | Time window for intravenous thrombolysis after acute ischemic stroke: evidence and next steps
Qi Li, MD, PhD, The Second Affiliated Hospital of Anhui Medical University, Hefei, China, shares insights into the use of intravenous (IV) thrombolysis for ischemic stroke within 4.5 to 24 hours after symptom onset. Prof. Li notes that IV thrombolysis is effective in this time window for selected patients, and the next step is to identify which patients will benefit the most. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.
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Transcript
In our analysis of the patients presenting within 4.5 to 24 hours after symptom onset, we found that thrombolysis may improve functional outcome within this specific time window in selected patients. And I think the question to come is that how could we choose patients that will benefit from thrombolysis? I think it should be based on advanced imaging. So in our department, we use like emergency MRI as an initial exam for patients with acute ischemic stroke...
In our analysis of the patients presenting within 4.5 to 24 hours after symptom onset, we found that thrombolysis may improve functional outcome within this specific time window in selected patients. And I think the question to come is that how could we choose patients that will benefit from thrombolysis? I think it should be based on advanced imaging. So in our department, we use like emergency MRI as an initial exam for patients with acute ischemic stroke. And we found that a significant proportion of patients presenting from 4.5 hours to 24 hours may benefit from the IV thrombolysis. Now in our department we found that two-thirds of the patients with thrombolysis within 24 hours were between the 4.5 to 24-hour time window based on DWI flare mismatch.
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