Would you consider off-label IV thrombolysis in patients taking a DOAC and present with disabling acute ischemic stroke within the window?  

I usually do not (since there is still equipoise) unless they are not an acute trial or thrombectomy candidate and have severe disabling deficits, and only if their last DOAC dose was not within 24 hours rather than 48 hours. I also discuss in detail the unknown and the risks with patients or their ...