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Thrombolytic therapies for ischemic stroke: Triumphs and future challenges
Aimen Moussaddy1, Andrew M Demchuk2, Michael D Hill2
1Calgary Stroke Program, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Neuropharmacology
|March 6, 2018
Summary
Acute stroke therapy has advanced with thrombolysis and mechanical thrombectomy, improving patient outcomes. Research now focuses on biomarkers and combining treatments for better results in acute ischemic stroke.
Area of Science:
- Neurology
- Vascular Neurology
- Emergency Medicine
Background:
- Acute stroke is a leading cause of long-term disability globally.
- Therapeutic options for acute stroke have seen significant advancements.
- Identifying predictors for successful treatment is crucial.
Purpose of the Study:
- To review the evolution of acute stroke therapy.
- To discuss the fundamentals of stroke treatment, including time, recanalization, and perfusion.
- To highlight recent advances and future directions in stroke reperfusion therapy.
Main Methods:
- Literature review of key advancements in acute stroke treatment.
- Focus on intravenous thrombolysis and intra-arterial mechanical thrombectomy.
- Analysis of recent trials and emerging therapeutic agents like tenecteplase.
Main Results:
- Intravenous thrombolysis (since 1995) and mechanical thrombectomy (since 2015) have improved functional outcomes.
- Biomarkers and imaging are key for selecting treatment candidates.
- Tenecteplase shows promise as a novel thrombolytic agent.
Conclusions:
- Acute stroke therapy has dramatically improved functional outcomes.
- Future research should focus on optimizing bridging therapy (chemical and mechanical thrombolysis).
- Understanding time, recanalization, and collateral perfusion remains fundamental.
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