J Korean Med Assoc.  2013 May;56(5):402-409.

Recent advances in thrombolysis of acute ischemic stroke

Affiliations
  • 1Department of Neurology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea.
  • 2Department of Neurology, Inha University College of Medicine, Incheon, Korea. jhrha@inha.ac.kr

Abstract

Among the many advances in acute ischemic stroke (AIS) management, thrombolysis with intravenous (IV) tissue plasminogen activator (tPA) within 3 hours after symptom onset has been the only approved pharmacological therapy in AIS. However, IV administration of tPA has many limitations in clinical practice, and the proportion of eligible patients remains quite low. Many clinical trials have attempted to overcome this by increasing the therapeutic time window and enhancing the efficacy of reperfusion by the intra-arterial (IA) approach with novel mechanical devices. In addition, the application of new thrombolytic agents and identification of suitable thrombolytic candidates by multimodal brain imaging is another field of active research in thrombolytic therapy. We reviewed AIS management, focusing on thrombolysis with IV therapy, IA therapy, and IV-IA bridging therapy.

Keyword

Acute ischemic stroke; Tissue plasminogen activator; Thrombolysis; Intravenous thrombolysis; Intra-arterial thrombolysis

MeSH Terms

Fibrinolytic Agents
Humans
Neuroimaging
Reperfusion
Stroke
Thrombolytic Therapy
Tissue Plasminogen Activator
Fibrinolytic Agents
Tissue Plasminogen Activator
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