Thrombolysis for acute ischemic stroke: Future directions |
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| Affiliation: | 1. State Key Laboratory of Powder Metallurgy, Central South University, Changsha, Hunan 410083, P. R. China;2. National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences and Collaborative, Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, P. R. China;3. School of Materials Science and Engineering, Beihang University, Beijing 100191, P. R. China;4. Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta, T6G 1H9 Canada;1. Faculty of Materials and Manufacturing, Key Laboratory of Advanced Functional Materials, Education Ministry of China, Beijing University of Technology, Beijing 100124, P.R. China;2. Institut National de la Recherche Scientifique-Énergie Matériaux et Télécommunications, Varennes, Québec, J3X1S2, Canada |
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| Abstract: | Intravenous tissue plasminogen activator remains the standard for treating acute ischemic stroke. Citicoline, dizocilpine, nimodipine, tirilizad, and other agents have been tested with thrombolytics in preclinical trials with mixed but encouraging results. Lessons from prior failed attempts to develop neuroprotectives as monotherapies should be applied to the development of combination therapies. In the future, there will be efforts to improve reperfusion rates without increasing intracranial hemorrhage rates. In addition to studying intra-arterial thrombolysis, there is a need for further testing of newer fibrinolytics and combination antithrombotics. Advancements in neuroimaging also will allow more tailored use of thrombolytic therapy. |
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