In patients presenting with disabling acute ischemic stroke symptoms early in the therapeutic window, would you consider anticoagulation reversal to enable administration of intravenous thrombolytics?  

In short, 'no'. For patients who have a large vessel occlusion, there is the option of proceeding directly to EVT without thrombolysis. We know from the direct EVT trials that although concurrent or sequential thrombolytic drug treatment followed by EVT is better, it is better only by a small amount...

Creating a prothrombotic state.