title: Treatment of acute ischemic stroke: from fibrinolysis to neurointervention.
abstract: Thrombolytic therapy with intravenous recombinant tissue plasminogen activator is well established as a beneficial treatment for patients presenting with acute ischemic stroke (AIS). The odds of a favorable clinical outcome (living independently) increase as the time between stroke onset and treatment with IV thrombolysis decreases. However, many patients present with a large clot burden that seldom responds to systemic fibrinolysis. Alternative options include new and emerging endovascular therapies that have recently proven effectiveness at restoring cerebral blood flow to the ischemic brain parenchyma. This review article will briefly outline some of the key evidence for intravenous thrombolysis as well as endovascular therapy for AIS.
authors.affiliation: Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: G J
authors.initials: GJ
authors.lastname: Jacquin
authors.affiliation: Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON, Canada.|Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.|Diagnostic Imaging, Department of Radiology, McMaster University, Hamilton, ON, Canada.
authors.forename: B A
authors.initials: BA
authors.lastname: van Adel
mesh_terms: D000818:Animals; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects; D005342:Fibrinolysis / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D061665:Time-to-Treatment; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: mechanical thrombolysis; stroke; thrombectomy; thrombolytic therapy; tissue plasminogen activator