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To Lyse or Not to Lyse: The Great tPA Debate

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It’s been a few months since I’ve posted (a little over six, whoops), but as they say – new year new me. I’m planning on trying to stick to a once a month or so posting schedule so hopefully that goes well! I’m kicking 2024 off with a real doozy – does thrombolysis really work in stroke? Got your attention, maybe? Yes, this debate is withered and old and the same arguments from both sides get circulated routinely about the putative risks and benefits of providing a guideline-supported therapy with decades of supporting evidence to patients who are experiencing a neurologic emergency which has the potential to permanently alter their entire life. Ok, ok – that is the only bit of sass I’ll allow myself. Key Points Thrombolysis for eligible acute ischemic stroke patients is guideline-recommended and backed by strong evidence, but controversy remains over the merits of the evidence Objection #1: There is No Positive Data for Thrombolysis Re-analyses of positive