Intravenous thrombolysis in acute ischemic stroke

Standard and potential future applications

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Acute ischemic stroke is a medical emergency requiring urgent treatment. Randomized clinical trial and Phase IV data have provided unequivocal evidence that intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) improves early functional outcomes by restoring brain perfusion. Moreover, these studies have shed substantial light on the factors which are associated with more favorable outcome with tPA and are related to the highest benefit-to-risk ratio. Stroke physicians should consider vascular imaging techniques to aid decision making with thrombolytic therapy. The presence of intracranial occlusion is the target of treatment with early recanalization being the goal. Successful use of intravenous thrombolysis depends on a sound understanding of the decision-making process and organization of the treating team who strives for early treatment initiation and strict adherence to the protocol. Intravenous rt-PA within 4.5 h of onset should now be a standard treatment of acute disabling ischemic stroke throughout the world. This review also summarizes intravenous thrombolysis contraindications as well as the safety of novel reperfusion therapies including tenecteplase, sonothrombolysis and the combination of alteplase with direct thrombin inhibitors or glycoprotein IIb/IIIa receptor antagonists.

Original languageEnglish (US)
Pages (from-to)879-892
Number of pages14
JournalExpert Review of Neurotherapeutics
Volume14
Issue number8
DOIs
StatePublished - Jan 1 2014

Fingerprint

Stroke
Tissue Plasminogen Activator
Decision Making
Therapeutics
Platelet Glycoprotein GPIIb-IIIa Complex
Antithrombins
Thrombolytic Therapy
Reperfusion
Blood Vessels
Emergencies
Randomized Controlled Trials
Perfusion
Odds Ratio
Physicians
Safety
Brain

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Intravenous thrombolysis in acute ischemic stroke : Standard and potential future applications. / Haršány, Michal; Tsivgoulis, Georgios; Alexandrov, Andrei.

In: Expert Review of Neurotherapeutics, Vol. 14, No. 8, 01.01.2014, p. 879-892.

Research output: Contribution to journalReview article

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