8 months ago
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Posted On: February 23rd 2026, 01:50 am
🚨NEW GUIDELINE🚨
The American Heart Association / American Stroke Association 2026 Acute Ischemic Stroke Guideline now supports IV thrombolysis in select patients with unknown onset or 4.5–9 hour windows when perfusion imaging shows salvageable brain tissue.
This recommendation was driven in part by the New England Journal of Medicine EXTEND trial (Ma et al., 2019), which showed benefit of thrombolysis up to 9 hours or in wake-up strokes when guided by perfusion imaging.
🧠
🔗 EXTEND trial (NEJM):
https://www.nejm.org/doi/full/10.1056/NEJMoa1813046
🔗 AHA/ASA Acute Ischemic Stroke Guideline (latest version):
https://www.ahajournals.org/doi/10.1161/STR.0000000000000158
#resident #residency #neurology #stroke #timeisbrain
The American Heart Association / American Stroke Association 2026 Acute Ischemic Stroke Guideline now supports IV thrombolysis in select patients with unknown onset or 4.5–9 hour windows when perfusion imaging shows salvageable brain tissue.
This recommendation was driven in part by the New England Journal of Medicine EXTEND trial (Ma et al., 2019), which showed benefit of thrombolysis up to 9 hours or in wake-up strokes when guided by perfusion imaging.
🧠
🔗 EXTEND trial (NEJM):
https://www.nejm.org/doi/full/10.1056/NEJMoa1813046
🔗 AHA/ASA Acute Ischemic Stroke Guideline (latest version):
https://www.ahajournals.org/doi/10.1161/STR.0000000000000158
#resident #residency #neurology #stroke #timeisbrain
Comments (289)
7 months agobarefoot.chrissy.b
Spent 1/2 of my career, working acute stroke and I just found you and I’m just seeing this!! Awesomesauce!!
7 months agomrs.ashleyyy.wright
This makes me so nervous… literature doesn’t support positive outcomes with tnka and now we may be doing it to an even more inflamed brain
8 months agofrey.sandoval
No, it’s not bc of bleeding risk, it is because of reactive oxygen species and the damage causes by releasing those ROS by restoring blood flow. But it sounds like they reevaluated the risk vs benefit and decided the risk is worth it.
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