Over half of stroke survivors fail to achieve full recovery 90 days after thrombectomy for large-vessel ischemic stroke , prompting ongoing efforts to optimize postprocedural care. In this study, researchers evaluated whether adding intra-arterial alteplase after thrombectomy could improve outcomes in 433 adults (mean age, 76 years). Following successful clot removal, patients received either standard care alone or standard care plus a 15-minute intra-arterial infusion of alteplase within 24 hours of symptom onset. At 90 days, the alteplase group showed a 15% higher rate of favorable functional outcomes (57.5% vs. 42.5%) and a 22% lower risk of impaired microvascular perfusion (28.6% vs.
50.5%) compared with thrombectomy alone. Although bleeding (1.4% vs. 0.5%) and mortality (12.1% vs. 6.4%) were numerically higher with alteplase, these differences were not statistically significant.…
