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Volume 359:2839-2841 December 25, 2008 Number 26
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Thrombolysis 3 to 4.5 Hours after Acute Ischemic Stroke

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by Hacke, W.
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To the Editor: Since the 1995 publication of a study1 reporting the efficacy of intravenous thrombolysis with alteplase for limiting the devastating effects of acute ischemic stroke, we have learned repeatedly that successful thrombolysis is time-dependent. Despite initial skepticism regarding the benefit of such therapy, subsequent trials have replicated similar efficacy, effectiveness, and safety and have continued to emphasize that "time is brain." In the European Cooperative Acute Stroke Study (ECASS) III trial (Sept. 25 issue),2 Hacke et al. discuss the benefit of intravenous thrombolysis with alteplase administered up to 4.5 hours after the onset of stroke symptoms. Although the . . . [Full Text of this Article]



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