Reperfusion therapies for acute ischemic stroke: current pharmacological and mechanical approaches.

Abstract

Arterial recanalization and subsequent reperfusion have extensively demonstrated their ability to restore the brain function when performed shortly after acute ischemic stroke. However, arterial recanalization does not necessarily lead to brain tissue reperfusion. This review provides an update of current approaches to improve the efficacy profile of brain tissue reperfusion within and beyond the therapeutic window, including the use of novel thrombolytic agents, bridging intravenous and intra-arterial therapies, and mechanical clot retrieval or aspiration. There are still several challenges in the near future of reperfusion therapy for acute ischemic stroke, such as improving the ultra-early access to treatment within the "golden hour," extending the therapeutic window beyond the current 4.5-hour time window, and developing novel thrombolitics or combined approaches to improve treatment efficacy.