What are the benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischemic stroke?
The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischemic stroke have been studied in the Third International Stroke Trial (IST-3), which found that the treatment was associated with a reduction in death or dependency at 6 months compared to placebo. However, there was an increased risk of symptomatic intracerebral hemorrhage associated with this treatment. Other studies, such as the ENCHANTED trial, have also found that low-dose alteplase offers similar benefits to standard-dose alteplase in terms of mortality and functional outcomes, though there is an increased risk of symptomatic intracranial hemorrhage with low-dose alteplase. Overall, the benefits of thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischemic stroke outweigh the risks.  