Thrombolysis for ischaemic stroke is recommended up to 4·5 h from stroke onset.1 Beyond 4·5 h, endovascular clot retrieval2 is the standard of care in selected patients up to 24 h after the time they were last known to be well.3 However, immediate endovascular clot retrieval will not be available for all patients. In The Lancet, Bruce Campbell and colleagues4 report the findings of their meta-analysis of individual patient data from three intravenous thrombolysis trials (EXTEND,5 ECASS4-EXTEND,6 and EPITHET7) of late window (4·5–9 h) or wake-up stroke.
Original Article: [Comment] Late thrombolysis for stroke works, but how do we do it?