Neurológia pre prax 3/2014

Recanalization therapy of ischemic stroke – what next?

Acute occlusion of the cervical or intracranial cerebral artery is the most common cause of ischemic stroke. Early arterial recanalization with brain reperfusion is currently the most effective method of treatment of ischemic stroke. The gold standard of stroke reperfusion therapy is na intravenous thrombolysis with administration of 0.9 mg/kg tPA in hourly infusion. Intra-arterial thrombolysis and different mechanical recanalization methods of cerebral arteries including sonolysis are alternative treatment especially for patients who have failed systemic thrombolysis (recanalization of the artery) or a thrombolysis was contraindicated. Despite the rapid development of recanalization methods, their effectiveness remains limited not only therapeutic window, numerous contraindications, but also the fact that despite successful early recanalization of the artery only about 50–60 % of treated patients reach independency within 3 months. For these reasons it is necessary to look for other therapeutic approaches in the future.

Keywords: ischemic stroke, arterial occlusion, recanalization, therapy, sonolysis.