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Intravenous Alteplase for Stroke with Unknown Time of Onset Guided by Advanced Imaging:Systematic Review and Meta-Analysis of Individual Patient Data Lancet 396:1574-1585, Thomalla,G.,et al, 2020 See this aricle in Pubmed Article Abstract In patients who have had a stroke with unknown time of onset with DWI-FLAIR or perfusion mismatch, intravenous alteplase resulted in better functional outcome at 90 days than placebo or standard care. A net benefit was observed for all functional outcomes despite an increased risk of symptomatic intracranial haemorrhage. Although there were more deaths with alteplase than placebo, there were fewer cases of severe disability or death.

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