Alteplase and Adjuvant Therapies for Acute Ischemic Stroke

Adam L. Gottula; Andrew D. Barreto; Opeolu Adeoye

doi:10.1055/s-0040-1722720

Seminars in Neurology, Inhaltsverzeichnis

Semin Neurol 2021; 41(01): 016-027
DOI: 10.1055/s-0040-1722720

Review Article

Alteplase and Adjuvant Therapies for Acute Ischemic Stroke

Autoren

Adam L. Gottula

¹Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio
Andrew D. Barreto

²Department of Neurology, University of Texas Houston, Houston, Texas
Opeolu Adeoye

³Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri

Abstract

Acute ischemic stroke (AIS) is a time sensitive medical emergency and a leading cause of morbidity and mortality worldwide. Intravenous (IV) recombinant tissue plasminogen activator (IV alteplase) is currently the only proven effective medication for the treatment of AIS with promising adjuvant medications currently under investigation. Recent advances in endovascular thrombectomy have broadened therapeutic options in specific patient populations, with modern treatment strategies utilizing advanced imaging modalities to extend the window for treatment. In all cases, rapid treatment remains a priority. The future of IV alteplase and the changing standard for treatment of AIS remain unwritten with the increasing evidence for imaging selection for both endovascular thrombectomy and IV alteplase, while novel adjuncts are under investigation. In this article, we review the history of IV alteplase investigations for stroke, evidence for thrombectomy as an adjunct to IV alteplase, and the potential of novel adjuvant therapeutics currently under investigation.

Keywords

stroke - ischemic - alteplase - thrombectomy - argatroban - eptifibatide

Volltext

Referenzen

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