Intravenous thrombolysis (IVT) is a crucial treatment for acute stroke and its broad availability is valuable, considering not all patients qualify for endovascular treatment. Diana Aguiar de Sousa, MD, PhD, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal, talks about recent developments regarding IVT, including matters of implementation, indications. One key message is the importance of administering treatment promptly after symptom onset, as quicker treatment enhances efficacy. Thus, optimizing methodologies and workflow is crucial for better outcomes.
She further highlights the recent developments in stroke care that have led to important changes in the 2021 ESO guidelines, such as the demonstration of efficacy of MRI-guided thrombolysis for stroke with unknown time of onset in the WAKE-UP trial (NCT01525290), the extended time window in which IVT can be safely and effectively applied based on target mismatch criteria, and the value of tenecteplase for IVT. Challenges in implementing imaging techniques and recent shortages of tenecteplase and TPA were also discussed. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.

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