Thrombolysis in ischemic stroke: focus on new treatment strategies

Stroke is the third leading cause of death and the main cause of permanent disability in western countries. Reperfusion within 3 hours of symptoms-onset is the most beneficial of all therapeutic strategies for acute ischemic stroke. Alteplase has been the first thrombolytic treatment approved by FDA. However, its use is still limited to specific patient subgroups and may be complicated by severe side effects, including massive cerebral hemorrhages. This review is aimed at investigating the current and future treatment strategies in ischemic stroke, including new fibrinolytic drugs, sonothrombolysis, mechanical clot retrievals, and recent patents.