A Revised Novel Approach of Ischemic Stroke through Thrombolytic Therapy and Thrombectomy

PDF Review History

Published: 2024-01-02

Page: 1-11


Akula Ruchitha Sai

Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, (RIPER) – Autonomous, KR Palli Cross, Chiyyedu (Post), Anantapur, Andhra Pradesh- 515721, India.

Aaravula Hemanth Babu

Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, (RIPER) – Autonomous, KR Palli Cross, Chiyyedu (Post), Anantapur, Andhra Pradesh- 515721, India.

Mopuri jyothsna

Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, (RIPER) – Autonomous, KR Palli Cross, Chiyyedu (Post), Anantapur, Andhra Pradesh- 515721, India.

K. Somasekhar Reddy

Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, (RIPER) – Autonomous, KR Palli Cross, Chiyyedu (Post), Anantapur, Andhra Pradesh- 515721, India.

A. Sudheer *

Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, (RIPER) – Autonomous, KR Palli Cross, Chiyyedu (Post), Anantapur, Andhra Pradesh- 515721, India.

*Author to whom correspondence should be addressed.


Abstract

This comprehensive overview analyses the development of ischemic stroke therapy, emphasizing the critical significance that thrombolytic therapy and thrombectomy techniques have played. With a particular set of difficulties, thrombolytic therapy tissue plasminogen activator, or tPA has revolutionized acute stroke care by breaking up clots in a crucial window of time. Simultaneously, thrombectomy has become a revolutionary intervention, especially for large-vessel occlusions, offering a localized, effective approach and expanding therapy windows. This review guides you through the historical events, technological developments, and continuing research that have shaped these methods. The importance of individualized treatment plans, the use of telemedicine, and the bright future prospects for the management of ischemic strokes are emphasized.

Keywords: Thrombectomy, thrombolytic therapy, ischemic cascade, aspiration catheters, stent retrieval, combined therapy


How to Cite

Sai , A. R., Babu , A. H., jyothsna, M., Reddy, K. S., & Sudheer, A. (2024). A Revised Novel Approach of Ischemic Stroke through Thrombolytic Therapy and Thrombectomy. Asian Journal of Advances in Medical Science, 6(1), 1–11. Retrieved from https://journalmedicals.com/index.php/AJOAIMS/article/view/143


References

Kernich CA. Ischemic stroke. The Neurologist. 2007;13(4):235-6.

Lyaker MR, Tulman DB, Dimitrova GT, Pin RH, Papadimos TJ. Arterial embolism. International journal of critical illness and injury science. 2013;3(1):77.

Welch WH. Thrombosis and embolism; 1899.

Moretti A, Ferrari F, Villa RF. Neuroprotection for ischaemic stroke: current status and challenges. Pharmacology & therapeutics. 2015;146: 23-34.

Ali MR, Salim Hossain M, Islam MA, Arman SI, Sarwar Raju G, Dasgupta P, Noshin TF. Aspect of thrombolytic therapy: a review. The Scientific World Journal. 2014;2014.

Munich SA, Vakharia K, Levy EI. Overview of mechanical thrombectomy techniques. Neurosurgery. 2019;85(suppl_1):S60-S7.

Li Y, Yang G-Y. Pathophysiology of ischemic stroke. Translational research in stroke. 2017;51-75.

Grory BM, Fakhri N, Yaghi S. Thrombotic Strokes. Cerebrovascular Disorders. 2021; 243-60.

Mir MA, Al-Baradie RS, Alhussainawi MD. Pathophysiology of strokes. Recent Advances in Stroke Therapeutics 1st ed Nova Science Publishers, Inc. 2014;25-80.

Wolberg AS, Rosendaal FR, Weitz JI, Jaffer IH, Agnelli G, Baglin T, Mackman N. Venous thrombosis. Nature reviews Disease primers. 2015;1(1):1-17.

Lippi G, Franchini M, Targher G. Arterial thrombus formation in cardiovascular disease. Nature Reviews Cardiology. 2011;8(9):502-12.

Endres M, Dirnagl U, Moskowitz MA. The ischemic cascade and mediators of ischemic injury. Handbook of clinical neurology. 2008;92:31-41.

Bretón RR, Rodríguez JCG. Excitotoxicity and oxidative stress in acute ischemic stroke. Acute ischemic stroke. 2012;200: 29-50.

Nanetti L, Taffi R, Vignini A, Moroni C, Raffaelli F, Bacchetti T, et al. Reactive oxygen species plasmatic levels in ischemic stroke. Molecular and cellular biochemistry. 2007;303:19-25.

Lakhan SE, Kirchgessner A, Hofer M. Inflammatory mechanisms in ischemic stroke: therapeutic approaches. Journal of translational medicine. 2009;7(1):1-11.

Sevitt S. Thrombosis and embolism after injury. Journal of Clinical Pathology Supplement (Royal College of Pathologists). 1970;4:86.

Adams Jr HP, Biller J. Classification of subtypes of ischemic stroke: history of the trial of org 10 172 in acute stroke treatment classification. Stroke. 2015;46(5):e114-e7.

Adams Jr HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh 3rd E. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. stroke. 1993; 24(1):35-41.

Mosconi MG, Paciaroni M. Treatments in ischemic stroke: current and future. European neurology. 2022;85(5):349-66.

Ortolano S, Spuch C. tPA in the central nervous system: relations between tPA and cell surface LRPs. Recent patents on endocrine, metabolic & immune drug discovery. 2013;7(1):65-76.

Blakeley JO, Llinas RH. Thrombolytic therapy for acute ischemic stroke. Journal of the Neurological Sciences. 2007;261(1-2):55-62.

Sherry S. The history and development of thrombolytic therapy: JB Lippincott Co: Philadelphia; 1995.

O’Connor RE, McGraw P, Edelsohn L. Thrombolytic therapy for acute ischemic stroke: why the majority of patients remain ineligible for treatment. Annals of emergency medicine. 1999;33(1):9-14.

Majidi S, Luby M, Lynch JK, Hsia AW, Benson RT, Kalaria CP, et al. MRI-based thrombolytic therapy in patients with acute ischemic stroke presenting with a low NIHSS. Neurology. 2019;93(16):e1507-e13.

Baig MU, Bodle J. Thrombolytic therapy. StatPearls [Internet]: StatPearls Publishing; 2022.

Lyden PD, Lyden P. Thrombolytic therapy for stroke: Springer; 2001.

Nakamura S, Takano H, Kubota Y, Asai K, Shimizu W. Impact of the efficacy of thrombolytic therapy on the mortality of patients with acute submassive pulmonary embolism: a meta‐analysis. Journal of Thrombosis and Haemostasis. 2014;12(7): 1086-95.

Daley MJ, Murthy MS, Peterson EJ. Bleeding risk with systemic thrombolytic therapy for pulmonary embolism: scope of the problem. Therapeutic advances in drug safety. 2015;6(2):57-66.

Hollist M, Morgan L, Cabatbat R, Au K, Kirmani MF, Kirmani BF. Acute stroke management: overview and recent updates. Aging and disease. 2021;12(4): 1000.

Xu Z-H, Deng Q-W, Zhai Q, Zhang Q, Wang Z-J, Chen W-X, et al. Clinical significance of stroke nurse in patients with acute ischemic stroke receiving intravenous thrombolysis. BMC neurology. 2021;21(1):1-8.

Jadhav AP, Molyneaux BJ, Hill MD, Jovin TG. Care of the post-thrombectomy patient. Stroke. 2018;49(11):2801-7.

Jadhav AP, Desai SM, Jovin TG. Indications for mechanical thrombectomy for acute ischemic stroke: current guidelines and beyond. Neurology. 2021;97(20 Supplement 2):S126-S36.

Friedrich B, Boeckh-Behrens T, Krüssmann V, Mönch S, Kirschke J, Kreiser K, et al. A short history of thrombectomy–Procedure and success analysis of different endovascular stroke treatment techniques. Interventional neuroradiology. 2021;27(2):249-56.

Lv MX. The History and Development of Endovascular Neurosurgery. 2021.

Baron J-C. Selection of patients for thrombectomy in the extended time window. JAMA neurology. 2021;78(9): 1051-3.

Nguyen TN, Castonguay AC, Siegler JE, Nagel S, Lansberg MG, de Havenon A, et al. Mechanical thrombectomy in the late presentation of anterior circulation large vessel occlusion stroke: a guideline from the Society of Vascular and Interventional Neurology guidelines and Practice Standards Committee. Stroke: Vascular and Interventional Neurology. 2023;3(1): e000512.

Menon BK, Ospel JM, McTaggart RA, Nogueira RG, Demchuk AM, Poppe A, et al. Imaging criteria across pivotal randomized controlled trials for late window thrombectomy patient selection. Journal of neurointerventional surgery. 2021;13(11):985-9.

Fanous AA, Siddiqui AH. Mechanical thrombectomy: stent retrievers vs. aspiration catheters. Cor et Vasa. 2016;58(2):e193-e203.

Blanc R, Escalard S, Baharvadhat H, Desilles JP, Boisseau W, Fahed R, et al. Recent advances in devices for mechanical thrombectomy. Expert review of medical devices. 2020;17(7):697-706.

Alawieh A, Vargas J, Fargen KM, Langley EF, Starke RM, De Leacy R, et al. Impact of procedure time on outcomes of thrombectomy for stroke. Journal of the American College of Cardiology. 2019; 73(8):879-90.

Pilgram-Pastor SM, Piechowiak EI, Dobrocky T, Kaesmacher J, Den Hollander J, Gralla J, Mordasini P. Stroke thrombectomy complication management. Journal of neurointerventional surgery. 2021;13(10):912-7.

Murano G, Bick RL. Thrombolytic therapy. Basic Concepts Of Hemostasis: CRC Press. 2019:259-68.

Rajendram P, Ikram A, Fisher M. Combined Therapeutics: Future Opportunities for Co-therapy with Thrombectomy. Neurotherapeutics. 2023; 1-12.

Rivera-Lebron B, Weinberg A. Approach to thrombolytic (fibrinolytic) therapy in Acute pulmonary embolism: Patient selection and administration. U: UpToDate [Internet] Waltham, MA: UpToDate; 2023.

Geisbush TR, Snyder SJ, Heit JJ. Neuroimaging in Patient Selection for Thrombectomy, From the AJR Special Series on Emergency Radiology. American Journal of Roentgenology. 2023;220(5): 630-40.

Zhang RS, Maqsood MH, Sharp AS, Postelnicu R, Sethi SS, Greco A, et al. Efficacy and safety of anticoagulation, catheter-directed thrombolysis, or systemic thrombolysis in acute pulmonary embolism. JACC: Cardiovascular Interventions. 2023;16(21):2644-51.

Karam A, Bricout N, Khyeng M, Cordonnier C, Leclerc X, Henon H, Casolla B. Safety and outcome of mechanical thrombectomy in ischaemic stroke related to carotid artery dissection. Journal of Neurology. 20211-8.

Lyden PD. Thrombolytic therapy for acute ischemic stroke: A very great honor. Stroke. 2019;50(9):2597-603.

Ganesh A, Goyal M. Thrombectomy for acute ischemic stroke: recent insights and future directions. Current neurology and neuroscience reports. 2018;18:1-13.

Gauberti M, de Lizarrondo SM, Vivien D. Thrombolytic strategies for ischemic stroke in the thrombectomy era. Journal of Thrombosis and Haemostasis. 2021;19(7): 1618-28.

Barthels D, Das H. Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2020;1866(4): 165260.

Saceleanu VM, Toader C, Ples H, Covache-Busuioc R-A, Costin HP, Bratu B-G, et al. Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations. Biomedicines. 2023;11(10):2617.