Abstract

The field of acute stroke treatment has made tremendous progress in reducing the overall burden of disability. Understanding the pathophysiology of acute ischemic injury, neuroimaging to quantify the extent of penumbra and infarction, and acute stroke reperfusion therapies have together contributed to these advancements. In this review we highlight advancements in reperfusion therapies for acute ischemic stroke.

Highlights

  • Acute ischemic stroke occurs due to sudden obstruction of blood flow of a cerebral artery leading to lack of oxygenation of the downstream brain tissue

  • Intravenous thrombolysis has remained the mainstay of reperfusion therapy for acute ischemic stroke patients since the 1990s

  • It has widely been observed that patients with an acute ischemic stroke secondary to a proximal intracranial large vessel occlusion (LVO) benefit significantly less from

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Summary

Introduction

Acute ischemic stroke continues to pose a significant challenge for our healthcare system. 85% of strokes are caused by an ischemic event and among those who survive a significant number require assistance with their daily activities [1]. Despite these grim numbers, there have been several notable advances in the past two decades that have transformed our approach to both diagnosis and treatment of patients with acute ischemic stroke. The purpose of this review is to summarize the principles and current understanding of the treatment options available for ischemic stroke focused on the hyperacute and acute stages

Basic Principles of Acute Stroke Reperfusion Therapy
Intravenous Thrombolysis
Alteplase
Tenecteplase
Endovascular Mechanical Thrombectomy
Future Directions
Findings
Conclusions

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