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https://www.ninds.nih.gov/About-NINDS/Impact/NINDS-Contributions-Approved-Therapies/Tissue-Plasminogen-Activator-Acute#:~:text=When%20administered%20quickly%20after%20stroke%20onset%20%28within%20three,limiting%20the%20risk%20of%20damage%20and%20functional%20impairment.
https://stopstroke.massgeneral.org/pdfs/Protocol%20(IV%20tPA%20in%20the%203-4.5hrs).pdf
Protocol for use of IV tPA in the 3-4.5 hour window 1. rtPA should be administered to eligible patients who can be treated in the time period of 3 to 4.5 hours after stroke.* 2. Exclusion criteria additional to the current guidelines for IV thrombolysis should be considered(see "Additional Warnings" below). The efficacy of IV rtPA within 3 to 4.5
https://journalfeed.org/article-a-day/2017/why-we-give-tpa-in-stroke
Use of tPA within 3 hours for acute ischemic stroke improved functional outcome at 3 months but increased early risk for intracranial hemorrhage. You need to know this study, so here are some suggested resources to get you started.
https://pubmed.ncbi.nlm.nih.gov/11988629/
Background: The use of recombinant tissue plasminogen activator (rtPA) within 3 hours after onset of an ischemic stroke is an established therapy. Because the use of intravenous rtPA beyond a time window of 3 hours after stroke onset is still a matter of debate, we sought to review the evidence for the use of thrombolytic therapy in a time window up to 6 hours after onset of symptoms of ...
https://forums.studentdoctor.net/threads/why-cant-you-give-tpa-after-3-hours.248281/
Dec 27, 2005. #4. Nothing says you can't give IV-tPA after 3 hours, however the NINDS study choose 3 hours as the cut-off time in their protocol basically because someone thought after 3 hours there would be no viable brain tissue left in the infarcted territory.
https://www.ahajournals.org/doi/full/10.1161/01.STR.0000015555.21285.DB
Background— The use of recombinant tissue plasminogen activator (rtPA) within 3 hours after onset of an ischemic stroke is an established therapy. Because the use of intravenous rtPA beyond a time window of 3 hours after stroke onset is still a matter of debate, we sought to review the evidence for the use of thrombolytic therapy in a time window up to 6 hours after onset of symptoms of …
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