A review of recent international literature on rt-PA intravenous therapy for stroke. The study focuses on the effectiveness of rt-PA in mild stroke cases, elderly patients, cases without reperfusion after rt-PA, and the effectiveness of 0.6 mg/kg rt-PA in Japan. In mild stroke cases with NIHSS scores of 5 or less, rt-PA therapy was found to be safe and effective, with lower rates of symptomatic intracerebral hemorrhage and better outcomes at 90 days. In a study of 32 patients with NIHSS scores of 5 or less, rt-PA therapy led to significant reductions in NIHSS scores at 24 hours and at discharge, with only 2 cases having mRS of 2 and 1 case with asymptomatic intracerebral hemorrhage. The study concluded that rt-PA therapy is beneficial for patients with NIHSS scores of 5 or less. In elderly patients (≥90 years), rt-PA therapy did not improve outcomes, with 10 patients dying and 5 having mRS of 4 or 5. There was also a 14% incidence of asymptomatic intracerebral hemorrhage. For patients who did not achieve reperfusion after rt-PA, additional therapies such as intra-arterial thrombolysis (IA) were effective. In a study of 18 patients, 16 achieved reperfusion (88.9%), with 12 patients having a good outcome (mRS 0-2) at discharge. One case of symptomatic intracerebral hemorrhage was reported. The Penumbra Stroke System was also effective in achieving reperfusion, although the 90-day mRS 0-2 rate was 25%, and the rate of symptomatic intracerebral hemorrhage was 11.2%. In Japan, rt-PA at a dose of 0.6 mg/kg was found to be effective in some cases, but not in all. In a study of 600 patients, rt-PA at 0.6 mg/kg was associated with a lower rate of symptomatic intracerebral hemorrhage and better outcomes at 3 months. However, in cases of internal carotid artery occlusion, the effectiveness was limited. The study also highlights the importance of having at least three stroke physicians in a facility for effective rt-PA treatment. Additionally, the use of MRI, DWI, MRA, and other imaging techniques increased after rt-PA approval in Japan. Overall, the review highlights the effectiveness of rt-PA in mild stroke cases and the importance of additional therapies for patients who do not achieve reperfusion. It also emphasizes the need for further research to improve outcomes in elderly patients and those with internal carotid artery occlusion.A review of recent international literature on rt-PA intravenous therapy for stroke. The study focuses on the effectiveness of rt-PA in mild stroke cases, elderly patients, cases without reperfusion after rt-PA, and the effectiveness of 0.6 mg/kg rt-PA in Japan. In mild stroke cases with NIHSS scores of 5 or less, rt-PA therapy was found to be safe and effective, with lower rates of symptomatic intracerebral hemorrhage and better outcomes at 90 days. In a study of 32 patients with NIHSS scores of 5 or less, rt-PA therapy led to significant reductions in NIHSS scores at 24 hours and at discharge, with only 2 cases having mRS of 2 and 1 case with asymptomatic intracerebral hemorrhage. The study concluded that rt-PA therapy is beneficial for patients with NIHSS scores of 5 or less. In elderly patients (≥90 years), rt-PA therapy did not improve outcomes, with 10 patients dying and 5 having mRS of 4 or 5. There was also a 14% incidence of asymptomatic intracerebral hemorrhage. For patients who did not achieve reperfusion after rt-PA, additional therapies such as intra-arterial thrombolysis (IA) were effective. In a study of 18 patients, 16 achieved reperfusion (88.9%), with 12 patients having a good outcome (mRS 0-2) at discharge. One case of symptomatic intracerebral hemorrhage was reported. The Penumbra Stroke System was also effective in achieving reperfusion, although the 90-day mRS 0-2 rate was 25%, and the rate of symptomatic intracerebral hemorrhage was 11.2%. In Japan, rt-PA at a dose of 0.6 mg/kg was found to be effective in some cases, but not in all. In a study of 600 patients, rt-PA at 0.6 mg/kg was associated with a lower rate of symptomatic intracerebral hemorrhage and better outcomes at 3 months. However, in cases of internal carotid artery occlusion, the effectiveness was limited. The study also highlights the importance of having at least three stroke physicians in a facility for effective rt-PA treatment. Additionally, the use of MRI, DWI, MRA, and other imaging techniques increased after rt-PA approval in Japan. Overall, the review highlights the effectiveness of rt-PA in mild stroke cases and the importance of additional therapies for patients who do not achieve reperfusion. It also emphasizes the need for further research to improve outcomes in elderly patients and those with internal carotid artery occlusion.