Experimental treatments for acute ischaemic stroke

Summary Treatments for acute ischaemic stroke continue to evolve. Experimental approaches to restore cerebral perfusion include techniques to augment recanalising therapies, including combination of antiplatelet agents with intravenous thrombolysis, bridging therapy of combining intravenous with int...

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Bibliographic Details
Published in:The Lancet (British edition) 2007-01, Vol.369 (9558), p.331-341
Main Authors: Sacco, Ralph L, Dr, Chong, Ji Y, MD, Prabhakaran, Shyam, MD, Elkind, Mitchell SV, MD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Clinical trials
Drug therapy
Drug Therapy, Combination
Fibrinolytic Agents - therapeutic use
General aspects
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypertension
Hypothermia
Internal Medicine
Magnesium
Male
Medical sciences
Middle Aged
Neurology
Neuroprotective Agents - therapeutic use
Platelet Aggregation Inhibitors - therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors
Randomized Controlled Trials as Topic
Statins
Stroke
Stroke - drug therapy
Stroke - therapy
Ultrasonic Therapy - methods
Vascular diseases and vascular malformations of the nervous system
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Summary:Summary Treatments for acute ischaemic stroke continue to evolve. Experimental approaches to restore cerebral perfusion include techniques to augment recanalising therapies, including combination of antiplatelet agents with intravenous thrombolysis, bridging therapy of combining intravenous with intra-arterial thrombolysis, and trials of new thrombolytic agents. Trials with MRI selection criteria are underway to expand the window of opportunity for thrombolysis. Sonothrombolysis and novel endovascular mechanical devices to retrieve or dissolve acute cerebral occlusions are being tested. Approaches to improve cerebral perfusion with other devices and induced hypertension are also being considered. Although numerous neuroprotective agents have not shown benefit, trials of hypothermia, magnesium, caffeinol, high doses of statins, and albumin are continuing. The findings of these randomised trials are anticipated to allow improved treatment of patients with acute stroke.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(07)60155-X