Acute stroke therapy: beyond i.v. tPA.

Although intravenous tissue plasminogen activator (i.v. tPA) has been approved for treating acute ischemic stroke, it must be given within 3 hours of stroke onset and only after ruling out hemorrhagic stroke by computed tomography. Several medical centers are turning to angiography to guide intra-arterial infusion of thrombolytic agents and mechanical endovascular interventions.