Objective: To summarize the efficacy and safety of intravenous thrombolysis and the key time lines with an aim to optimize the process of emergent thrombolysis and improve the prognosis of patients.

Methods: The clinical records of 20 cases of hyper-early acute cerebral infarction treated with intravenous thrombolysis from January 2019 to October 2019 were retrospectively analyzed. The outcomes were summarized and the key time lines were calculated and compared with the time lines that are recommended by the expert consensus. After that, the reasons for in-hospital delay were analyzed and came up with suggestions to optimize the process of emergent thrombolysis.

Results: A total of 20 cases of hyper-early acute cerebral infarction treated with intravenous thrombolysis were enrolled, including 9 men and 11 women. The median age was 74.5 years old. The median time from entering the hospital to cranial CT scanning was 19.5 minutes. The median time from receiving blood sample to test report were 25.0 minutes. The median time from entering the hospital to cranial CT result was 39.5 minutes. The median time of informed consent and administration of thrombolytic drug was 27.5 minutes. The median door to needle time (DNT) was 63.5minutes. The cure rate was 30.0%, while the general effective rate was 90.0%. Moreover, the incidence of adverse events was 45.0% which mainly included mild bleeding of mouth and gums.

Conclusion: The efficacy and safety of intravenous thrombolysis on hyper-early acute cerebral infarction were generally good, but there was problem of in-hospital delay. Some measures such as strengthening public education on cerebral infarction, improving the technique of informed consent and pre-reserving thrombolytic drug in the emergency room should be taken, so as to further shorten the DNT.