Related Experiment Video
Updated: Oct 30, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Acute Stroke Management: Overview and Recent Updates
Mary Hollist1, Larry Morgan2, Rainier Cabatbat2
11Memorial Healthcare Institute for Neurosciences, Owosso, MI, USA.
Insights
Acute stroke care has advanced significantly, moving towards personalized treatments like mechanical thrombectomy and thrombolytics to preserve brain tissue and improve patient outcomes. Early intervention is crucial for better functional independence after stroke.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Emergency Medicine
Background:
- Stroke is a major cause of death and disability, with limited treatment options prior to the 1990s.
- Acute stroke management has seen significant progress, particularly for ischemic stroke, yet few patients receive timely treatment.
- Advances aim to expand treatment eligibility and improve outcomes for both hemorrhagic and ischemic stroke patients.
Purpose of the Study:
- To review recent advancements in acute ischemic stroke management.
- To discuss the evolving treatment paradigms, including mechanical thrombectomy and thrombolytics.
- To highlight the shift towards tissue preservation and individualized patient care.
Main Methods:
- Review of recent clinical trials and guidelines for acute ischemic stroke.
- Analysis of endovascular therapy (EVT) and intravenous thrombolysis (IV tPA) efficacy and time windows.
- Discussion of advanced neuroimaging techniques (CT, MRI) for patient selection.
Main Results:
- Numerous trials have expanded treatment eligibility for acute stroke.
- Current management focuses on reperfusion, tissue preservation, and minimizing secondary events.
- Individualized treatment strategies using multimodal imaging are becoming standard.
Conclusions:
- Acute stroke management is transitioning from time-window-based to tissue-based approaches.
- Mechanical thrombectomy and thrombolytics, including tenecteplase, are key components of modern stroke care.
- Optimizing acute stroke treatment improves functional independence and reduces long-term disability.
Abstract:
Stroke is a leading cause of morbidity and mortality in the United States. Whether hemorrhagic or ischemic, stroke leads to severe long-term disability. Prior to the mid-1990s, the treatment offered to a patient who presented with an acute stroke was mainly limited to antiplatelets. The lack of adequate treatment, in particular, one without reperfusion contributed to the disability that ensued. There have been many advances in stroke care within the past two decades, especially with the acute management of ischemic stroke. Even with these advances, it is quite alarming that only a fraction of patients receives acute stroke treatment. Numerous trials were conducted to broaden treatment eligibility in hopes that more patients can be treated acutely and safely. These trials have tested both the time window for IV tPA and endovascular therapy (EVT). Acute stroke management is moving from a universal time window approach to a concept of tissue preservation. Specifically, preserving cerebral blood flow, the penumbra, and reducing the risk of a second event. This movement is being executed through the use of multimodal CT and MRI, as well as individualizing treatment to our patients. Minimizing the initial effect of stroke changes the outcome and leads to an increased likelihood of functional independence. In this review, we discuss the recent updates of acute ischemic stroke management in regards to mechanical thrombectomy as well as thrombolytics including tenecteplase.
Related Concept Videos
01:23Atherosclerosis IV: Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:26Acute Coronary Syndrome V: Nursing Management
01:22Aneurysm IV: Nursing Management
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...