Thrombolysis for acute ischemic stroke: still a treatment for the few by the few

The National Institute of Neurological Disorders and Stroke (NINDS) trialwas groundbreaking.1It demonstrated that stroke patients could be admitted to hospital, scanned,and treated within 3 hours of stroke, a major achievement in the early 1990s.The Food and Drug Administration accepted the NINDS evidence (actuallyconducted as 2 consecutive trials, only 1 of which gave positive results) andlicensed recombinant tissue plasminogen activator (tPA) for the treatment ofstroke.