Note that the above guideline still states "Tenecteplase has not been shown to be superior or noninferior to tPA in acute stroke." Unlike DEFUSE-3, to which committee members got embargoed access to the data for consideration, and ultimately, last minute incorporation into the 2018 guidelines, results of EXTEND IA TNK came out too late The Clinical Guidelines for Stroke Management 2017 updates and supersedes the Clinical Guidelines for Stroke Management 2010.. The Clinical Guidelines have been updated in accordance with the 2011 NHMRC Standard for clinical practice guidelines and therefore recommendations are based on the best evidence available. Stroke 2017; 48:e343. Frontera JA, Lewin JJ 3rd, Rabinstein AA, et al. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Correction to: 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. National guidelines recommend the lowering of blood pressure in hypertensive patients below 185/110 mmHg prior to tPA administration, given the increased risk of hemorrhagic conversion and other adverse events in patients with uncontrolled hypertension. 26,39 Nevertheless, care should be taken to avoid hypotension, as aggressive blood pressure The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Last reviewed date: Feb. 2017 Practice Guidelines Acute Stroke Practice Guideline for Inpatient Management of Ischemic Stroke and Transien