There aren't excellent data to guide this decision. In general, I make a patient-specific decision. For all patients (both tPA treated and otherwise), I target <180/100. If they're TICI 0-1, I usually keep to that. With TICI 2a, I usually lower to <160 and with 2b/3 I usually lower to <140....

Agree with Dr. @de Havenon, there is new data from the ENCHANTED2 study (published in Lancet October 2022) now that in patients with persistently elevated SBP after achieving TICI 2b/c/3 reperfusion, that one should avoid SBP target < 120 mm Hg as this is associated with harm. However, this does...