Thrombolytic therapy in acute ischemic stroke - basic concepts.
Thrombolytic therapy with alteplase in acute ischemic stroke is currently established within 3 h from symptom onset in carefully selected patients. Expansion of the time window is being assessed in trials with alteplase and desmoteplase. Also, tenecteplase, reteplase and staphylokinase are being evaluated in stroke patients. A better understanding of the coagulation and fibrinolytic systems may provide insight into drug development, interactions, complications, and may ultimately improve patient triage and treatment regimens. Future adjuvant and additional therapies could prove useful for patients who do not benefit from standard thrombolytic treatment or may augment the overall gain.
Meretoja
Atte
A
Department of Neurology, Helsinki University Central Hospital, Finland. atte.meretoja@hus.fi
Tatlisumak
Turgut
T
D001777:Blood Coagulation / Q000502:physiology; D017024:Chemotherapy, Adjuvant; D005343:Fibrinolytic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006207:Half-Life; D006801:Humans; D008657:Metabolic Clearance Rate; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000502:physiology / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator