Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations
The primary aim of thrombolysis in acute ischemic stroke is recanalization of an occluded intracranial artery. Recanalization is an important predictor of stroke outcome as timely restoration of regional cerebral perfusion helps salvage threatened ischemic tissue. At present, intravenously administe...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.4061/2010/672064 |
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| author | Vijay K. Sharma Hock Luen Teoh Lily Y. H. Wong Jie Su Benjamin K. C. Ong Bernard P. L. Chan |
| author_facet | Vijay K. Sharma Hock Luen Teoh Lily Y. H. Wong Jie Su Benjamin K. C. Ong Bernard P. L. Chan |
| author_sort | Vijay K. Sharma |
| collection | DOAJ |
| description | The primary aim of thrombolysis in acute ischemic stroke is recanalization of an occluded intracranial artery. Recanalization is an important predictor of stroke outcome as timely restoration of regional cerebral perfusion helps salvage threatened ischemic tissue. At present, intravenously administered tissue plasminogen activator (IV-TPA) remains the only FDA-approved therapeutic agent for the treatment of ischemic stroke within 3 hours of symptom onset. Recent studies have demonstrated safety as well as efficacy of IV-TPA even in an extended therapeutic window. However, the short therapeutic window, low rates of recanalization, and only modest benefits with IV-TPA have prompted a quest for alternative approaches to restore blood flow in an occluded artery in acute ischemic stroke. Although intra-arterial delivery of the thrombolytic agent seems effective, various logistic constraints limit its routine use and as yet no lytic agent have not received full regulatory approval for intra-arterial therapy. Mechanical devices and approaches can achieve higher rates of recanalization but their safety and efficacy still need to be established in larger clinical trials. The field of acute revascularization is rapidly evolving, and various combinations of pharmacologic agents, mechanical devices, and novel microbubble/ultrasound technologies are being tested in multiple clinical trials. |
| format | Article |
| id | doaj-art-e8abd285a1884b4082e4859277368cd2 |
| institution | Kabale University |
| issn | 2042-0056 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-e8abd285a1884b4082e4859277368cd22025-02-03T01:30:29ZengWileyStroke Research and Treatment2042-00562010-01-01201010.4061/2010/672064672064Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and CombinationsVijay K. Sharma0Hock Luen Teoh1Lily Y. H. Wong2Jie Su3Benjamin K. C. Ong4Bernard P. L. Chan5Division of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeDivision of Neurology, Department of Medicine, National University Hospital, 119074, SingaporeThe primary aim of thrombolysis in acute ischemic stroke is recanalization of an occluded intracranial artery. Recanalization is an important predictor of stroke outcome as timely restoration of regional cerebral perfusion helps salvage threatened ischemic tissue. At present, intravenously administered tissue plasminogen activator (IV-TPA) remains the only FDA-approved therapeutic agent for the treatment of ischemic stroke within 3 hours of symptom onset. Recent studies have demonstrated safety as well as efficacy of IV-TPA even in an extended therapeutic window. However, the short therapeutic window, low rates of recanalization, and only modest benefits with IV-TPA have prompted a quest for alternative approaches to restore blood flow in an occluded artery in acute ischemic stroke. Although intra-arterial delivery of the thrombolytic agent seems effective, various logistic constraints limit its routine use and as yet no lytic agent have not received full regulatory approval for intra-arterial therapy. Mechanical devices and approaches can achieve higher rates of recanalization but their safety and efficacy still need to be established in larger clinical trials. The field of acute revascularization is rapidly evolving, and various combinations of pharmacologic agents, mechanical devices, and novel microbubble/ultrasound technologies are being tested in multiple clinical trials.http://dx.doi.org/10.4061/2010/672064 |
| spellingShingle | Vijay K. Sharma Hock Luen Teoh Lily Y. H. Wong Jie Su Benjamin K. C. Ong Bernard P. L. Chan Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations Stroke Research and Treatment |
| title | Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations |
| title_full | Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations |
| title_fullStr | Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations |
| title_full_unstemmed | Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations |
| title_short | Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations |
| title_sort | recanalization therapies in acute ischemic stroke pharmacological agents devices and combinations |
| url | http://dx.doi.org/10.4061/2010/672064 |
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