ABSTRACT
In 1996, the US Food and Drug Administration approved the use of intravenous (IV) recombinant tissue-plasminogen activator (rt-PA) for the treatment for acute ischemic stroke (AIS) based on the results of the National Institute of Neurological Disorders and Stroke IV rt-PA Stroke Study. The DAWN trial represented a new dawn for a conceptual and paradigm shift in stroke care from clock-based to tissue-based selection of patients with AIS who are likely to benefit from reperfusion therapy far beyond the first few hours from stroke onset. Treatment decisions can now be based on individualized imaging-based analyses. Prior studies had demonstrated the benefit of endovascular thrombectomy if performed within 6 hours of an ischemic stroke. Innovations in device technology and imaging, new opportunities to deliver neuroprotective therapies, and a rejuvenated stroke community will undoubtedly continue to advance stroke care to minimize the morbidity and mortality of this devastating disease.
