During which hours can thrombolytic therapy be attempted for acute ischemic stroke?

Thrombolytic therapy, specifically the use of tissue plasminogen activator (tPA), is indicated for the treatment of acute ischemic stroke within a time frame that maximizes the potential for restoring blood flow to the occluded vessel while minimizing the risk of complications such as hemorrhage. The recommended time window for administering tPA is typically within 3 to 4.5 hours from the onset of symptoms.

This window is based on clinical trials that have demonstrated a significant benefit of thrombolytics when given in this timeframe, where patients have shown better outcomes in terms of functional recovery compared to those treated outside this window. Beyond 4.5 hours, the risks of administering thrombolytics often outweigh the potential benefits due to the increased likelihood of intracerebral hemorrhage and poorer functional outcomes.

While some studies explore extending treatment options to patients with larger time windows, the standard guideline remains firmly established at 3 to 4.5 hours post-symptom onset for the administration of tPA in cases of ischemic stroke. This critical time frame is essential for healthcare providers to adhere to when managing suspected acute ischemic strokes, ensuring optimal patient care and recovery.