• Pratit Patel, Dileep Yavagal, and Priyank Khandelwal.
• Departments of Neurological Surgery, Rutgers University-New Jersey Medical School, Newark, New Jersey.
• J. Am. Coll. Cardiol. 2020 Apr 21; 75 (15): 1844-1856.

AbstractAcute ischemic stroke is the leading cause of disability and among the leading causes of mortality worldwide. Intravenous tissue plasminogen activator has been a cornerstone for treatment of acute ischemic stroke for more than 20 years; however, its use is limited due to a narrow therapeutic window, several contraindications, and low efficacy to recanalize the artery in large vessel occlusion. Recently, the addition of endovascular mechanical thrombectomy of large artery occlusion has revolutionized the stroke treatment for most disabling strokes. The paper reviews updates to the thrombolytic treatment as well as catheter-based treatment, and results from recent trials in the selection of patients in an extended time window using perfusion imaging.Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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