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After results of the pivotal NINDS intravenous thrombolysis (IV rtPA) trial were published in 1995, there has been a gradual extension of the time window from 3 hours to 4.5 hours, based on additional trials (ECASS II and III).

Intravenous Thrombolysis Is Relatively Safe and Effective in Elderly Patients Up to 6 Hours After Symptom Onset