title: Treatment of acute ischemic stroke: systemic or local?
abstract: Systemic treatment of acute ischemic stroke currently means intravenous infusion of plasminogen activator in patients with the stroke syndrome after exclusion of brain hemorrhage irrespective of whether thrombotic arterial obstruction is present or not. In contrast, local intra-arterial treatment requires digital subtraction angiography and means direct treatment of the arterial pathology with the aim of recanalization and brain tissue reperfusion. Randomized controlled trials that test these two treatment approaches are missing. This paper discusses whether the time-saving systemic treatment approach is more promising for acute ischemic stroke patients than is the time-consuming endovascular local approach.
authors.affiliation: Neuroradiology and Dresden University Stroke Center, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Ruediger.vonkummer@uniklinikum-dresden.de
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kummer
authors.forename: Johannes
authors.initials: J
authors.lastname: Gerber
mesh_terms: D000208:Acute Disease; D015901:Angiography, Digital Subtraction; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D015427:Reperfusion Injury / Q000517:prevention & control; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator