Jesús Fernando Briceño-DomínguezGrecia Bejarano-CarabeoRoberto GalvãoBárbara RodriguesAlejandro Quintero-VillegasSergio Iván Valdés‐Ferrer2026-03-222026-03-22202510.1016/j.ric.2025.100030https://doi.org/10.1016/j.ric.2025.100030https://andeanlibrary.org/handle/123456789/85977In 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.enMedicineThrombolysisRandomized controlled trialIschemic strokeStroke (engine)Internal medicineCardiologyClinical trialIntensive care medicineEmergency medicinereview