When might you soften the post-thrombolysis monitoring requirements for patients receiving TPA for acute stroke?

The recent study by Anderson et al., PMID 40412428, suggests that a pattern of reduced monitoring after tPA was noninferior to standard monitoring in patients with initial NIHSS < 10, treated within 2 hours of symptom onset. This is suggestive that the reduced monitoring protocol is safe in patients meeting these criteria. However, the study was not performed in the U.S., and one study is not definitive, so I would be cautious in carrying out these policies in the U.S. In addition, even the modified criteria are still only a small degree less intensive than the original ones, so I do not see a great advantage to the immediate adoption of these guidelines.