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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Drug treatment of acute ischemic stroke

Sameer Bansal1, Kiranpal S Sangha, Pooja Khatri

  • 1Department of Neurology, University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA.

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|February 6, 2013
PubMed

Insights

Acute ischemic stroke (AIS) treatment involves alteplase (recombinant tissue plasminogen activator) to dissolve clots. While the time window is short, new trials suggest extended treatment may benefit select AIS patients.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Emergency Medicine

Background:

  • Acute ischemic stroke (AIS) is a major cause of death and disability in the USA.
  • AIS results from blood vessel obstruction, leading to irreversible brain damage.
  • Current drug treatment relies on intravenous alteplase (rtPA) for thrombolysis.

Purpose of the Study:

  • To review the current drug treatment strategies for acute ischemic stroke.
  • To discuss the efficacy and limitations of alteplase (rtPA) administration.
  • To highlight the importance of timely intervention and supportive care in AIS management.

Main Methods:

  • Literature review of current AIS treatment guidelines and clinical trials.
  • Analysis of the mechanism of action and therapeutic window of alteplase.
  • Evaluation of supportive interventions and contraindications for acute stroke care.

Main Results:

  • Alteplase (rtPA) promotes clot lysis by activating plasminogen to plasmin.
  • The therapeutic time window for alteplase is typically 3-4.5 hours post-symptom onset.
  • Supportive care includes managing blood glucose, body temperature, and severe hypertension.
  • Anticoagulation and urgent antiplatelet therapy have limited acute benefits and carry risks.

Conclusions:

  • Alteplase remains the primary drug therapy for eligible AIS patients within the established time window.
  • Many AIS patients do not receive thrombolytic therapy due to delayed presentation.
  • Further research and clinical trials are crucial for developing new acute interventions for AIS.

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