ACT: QuICR & OPTIMISE is a Pragmatic Phase III randomized open-label registry-based trial with blinded end-point assessment. Enrolled acute ischemic stroke patients will be eligible to receive intravenous thrombolysis (Alteplase or Tenecteplase) as per current guidelines.

Over the three year study period, 1,600 patients will be treated with tPA or TNK, with followup at 90 days. The primary outcome measure will be a modified Rankin Scale (mRS) 0 or 1 at 90-120 days.