Efficacy and safety of delayed thrombolysis for ischemic stroke within 4.5–24 h: A systematic review and meta-analysis of randomized controlled trials

Abstract

In ischemic stroke, thrombolytics administered within 4.5-24h improve functional independence at 90 days, also increasing the risk of symptomatic intracranial hemorrhage. At this point, careful and individualized patient selection, including advanced imaging, is mandatory for thrombolysis beyond the conventional 4.5-h treatment window.