• Lancet neurology · May 2023

    Review

    Thrombolysis for acute ischaemic stroke: current status and future perspectives.

    • Georgios Tsivgoulis, Aristeidis H Katsanos, Else Charlotte Sandset, Guillaume Turc, Thanh N Nguyen, Andrew Bivard, Urs Fischer, and Pooja Khatri.
    • Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address: tsivgoulisgiorg@yahoo.gr.
    • Lancet Neurol. 2023 May 1; 22 (5): 418429418-429.

    AbstractAlteplase is currently the only approved thrombolytic agent for treatment of acute ischaemic stroke, but interest is burgeoning in the development of new thrombolytic agents for systemic reperfusion with an improved safety profile, increased efficacy, and convenient delivery. Tenecteplase has emerged as a potential alternative thrombolytic agent that might be preferred over alteplase because of its ease of administration and reported efficacy in patients with large vessel occlusion. Ongoing research efforts are also looking at potential improvements in recanalisation with the use of adjunct therapies to intravenous thrombolysis. New treatment strategies are also emerging that aim to reduce the risk of vessel reocclusion after intravenous thrombolysis administration. Other research endeavors are looking at the use of intra-arterial thrombolysis after mechanical thrombectomy to induce tissue reperfusion. The growing implementation of mobile stroke units and advanced neuroimaging could boost the number of patients who can receive intravenous thrombolysis by shortening onset-to-treatment times and identifying patients with salvageable penumbra. Continued improvements in this area will be essential to facilitate the ongoing research endeavors and to improve delivery of new interventions.Copyright © 2023 Elsevier Ltd. All rights reserved.

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