Abstract
Despite extensive research efforts, treatment options for acute ischemic stroke were limited until the mid-1990s. Since then, two major therapeutic developments—both aiming at restoration of cerebral blood flow within hours of symptom onset—have been made. The first was the introduction of intravenous thrombolytic therapy in the clinical routine following the publication of the National Institute of Neurological Disorders and Stroke trial in 1995. Intravenous thrombolysis with recombinant tissue plasminogen activator (r-tPA) proved to be safe and significantly improved the clinical outcome when used within 3 h after symptom onset. For the following 20 years, it would—with some refinements in use—remain the only reperfusion therapy for acute ischemic stroke with proven benefit. Recently—in 2015—endovascular thrombectomy demonstrated impressive efficacy in several large clinical trials and broadened treatment options, especially for strokes with proximal vessel occlusions. Together, these two treatments have contributed to a substantial improvement in clinical outcome. In this chapter we will focus on intravenous thrombolysis in acute ischemic stroke.
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Brand names: Activase, Cathflo Activase, Genentech (San Francisco, USA); Actilyse, Boehringer Ingelheim International (Ingelheim, Germany); Cathflo, Roche (Mississauga, Canada); Activacin, Kyowa Hakko Kirin (Tokyo, Japan); Grtpa, Tanabe Mitsubishi Pharma (Osaka, Japan).
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Schweikert, A., Kahles, T., Nedeltchev, K. (2017). Intravenous Thrombolysis for Acute Ischemic Stroke. In: Lee, SH. (eds) Stroke Revisited: Diagnosis and Treatment of Ischemic Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-10-1424-6_6
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DOI: https://doi.org/10.1007/978-981-10-1424-6_6
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