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Stroke in Iran, with more than 83 million population, is a leading cause of disability and mortality in adults. Stroke has higher incidence in Iran comparing the global situation and unfortunately the onset age of first ever stroke is dropping about 10 years.1 Intravenous thrombolysis, as an approved treatment in ischemic stroke, has been used only in some university or private hospitals in Iran since 2008.2 The main limit for this therapy in Iran was the lack of coverage by health insurance companies for tPA. A project for situation analysis of stroke cases entering to Imam Reza Hospital, a tertiary university hospital in North-West of Iran, was performed in 2010 by Neurosciences Research Center. The percentage of cases referring on time and eligible for thrombolysis, barriers, pitfalls and delay gaps in the hospital were detected.3 After analyzing and involving all the related authorities & departments of the Tabriz University of Medical Sciences and performing a maneuver, thrombolysis in all eligible stroke cases was systematically started as pilot in the hospital since 2010. Other centers such as Firoozgar Hospital in Tehran, Ghaem Hospital in Mashhad, Namazi Hospital in Shiraz, and Alzahra Hospital in Isfahan were active in thrombolysis but non-systematically.

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