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Thrombolysis Criteria TABLE 13.6 Criteria for Thrombolysis and Thrombectomy in Stroke Patients Thrombectomy Criteria e <4.5h since onset of symptoms © Haemorrhage ruled out with imaging ° >18 years of age Exclusion criteria Seizure at onset of symptoms INR >1.7 NIHSS score of <5 or >25 BP >180 mm Hg systolic Recent major surgery within 2 weeks Stroke, head injury or cranial surgery in past 3 months Previous brain haemorrhage On DOAC or therapeutic LMWH Previously independent (Modified Rankin Scale (mRS) score of 2 or better) Large vessel occlusion NIHSS score of >5 (significant neurological deficit) ¢ Offer thrombectomy within 6 hours of symptoms onset together with thrombolysis (if not contraindi- cated and within licensed time window) for people with confirmed acute ischaemic stroke involving the proximal anterior circulation ° Offer thrombectomy within 24 hours of symptoms onset to people who have confirmed acute isch- aemic stroke involving the proximal anterior/pos- terior circulation and there is potential to salvage brain tissue (low ASPECT score on CT imaging) DOAC, Direct oral anticoagulant; LMWH, low-molecular-weight heparin; mRS, Modified Rankin Scale; NIHSS, National Institutes Health Stroke Scale.