When is thrombolysis used for stroke?

Timing is everything: Lytic therapy for strokes has been effective both IV and direct infusion in the cerebral artery.The sooner the better. The pts who are not excluded for bleeding risk or allergies etc.Should be treates asap. Pts within first 1-2 hrs do the best. 2-3 hrs have modest recovery and after 3 hrs prob not going to get a clinically significant improvement. Ofcourse each pt is has his own risk vs benefit.

Up to 6 hours: Tpa (alteplase) can be used by vein up to 3 hours ( some patients 4.5 hours ) after onset of stroke symptoms. Tpa (alteplase) in the artery can be used up to 6 hours after onset ( up to 24 hours in basilar artery ).