No , they do not save lives . tPA does not ' save lives ' nor does early lysis ' save lives '. The literature for tPA administration is actually quite poor , with many trials being terminated early for futility . A recent metaanalysis showed that you will help as many people as you will kill when giving Alteplase for ischemic stroke . This is not a silver bullet for stroke and contrary to what you ' re told by neurologists , poor efficacy of tPA has nothing to do with delay to treatment . We do see better outcomes in a small subset of patients , specifically those who are tPA candidates who have a proximal largevessel occlusion . That does not mean we should be lysing everyone . These ambulances are a monumental waste of money . forstroke