Ischemic stroke is a devastating condition with a high burden of neurologic disability and death. As a systemic treatment, intravenous alteplase has been shown to be better than conservative care.Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of patients die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. The major reason for the limited efficacy of alteplase is the modest rate of early reperfusion among patients with a large-vessel occlusion. 

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