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Updated: May 29, 2025

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Therapeutic Options for Disabling Acute Ischemic Stroke.

Veronica Moreno-Gomez1, Jana J Wold1

  • 1Department of Neurology, University of Utah School of Medicine, 175 North Medical Drive, Salt Lake City, UT 84132, USA.

The Medical Clinics of North America
|February 1, 2025
PubMed
Summary
This summary is machine-generated.

Intravenous thrombolytic therapy and thrombectomy are effective treatments for acute ischemic stroke, even in severe cases with large ischemic cores or basilar artery occlusion. These interventions can be used for up to 24 hours, improving patient outcomes.

Keywords:
Acute ischemic strokeEndovascular thrombectomyThrombolysis

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Emergency Medicine

Background:

  • Ischemic stroke is a leading cause of disability in the US, affecting up to 3% of the population.
  • Effective and timely treatment is crucial for improving patient outcomes and reducing long-term disability.

Purpose of the Study:

  • To review the evidence supporting intravenous thrombolytic therapy, including tenecteplase, for acute ischemic stroke.
  • To discuss the extended use of thrombectomy for up to 24 hours in select stroke patients.
  • To highlight treatment options for patients with large ischemic cores and acute basilar artery occlusions.

Main Methods:

  • Literature review of studies on intravenous thrombolysis and mechanical thrombectomy for acute ischemic stroke.
  • Analysis of clinical guidelines and trial data.
  • Inclusion of a clinical case illustrating thrombectomy in a patient with a large ischemic core.

Main Results:

  • Intravenous thrombolytic therapy, including tenecteplase, is supported by strong evidence for acute ischemic stroke.
  • Mechanical thrombectomy is effective for up to 24 hours in patients with large ischemic cores and acute basilar artery occlusions.
  • The clinical case demonstrates successful thrombectomy in a patient with a large ischemic core.

Conclusions:

  • Tenecteplase and thrombectomy represent significant advancements in acute ischemic stroke management.
  • Extended treatment windows up to 24 hours are beneficial for select patients, including those with large ischemic cores and basilar artery occlusions.
  • These therapies offer hope for reducing disability and improving functional recovery in stroke survivors.