Recent advances in therapeutic strategies of hyperacute and acute ischemic stroke in Japan

: Intravenous thrombolysis using tissue plasminogen activator (IV t-PA) and endovascular recanalization therapy are performed for neurological recovery in hyperacute ischemic stroke patients. Antithrombotic agents are given to prevent neurological worsening and recurrence in acute ischemic stroke patients. Therapeutic strategies for hyperacute and acute ischemic stroke have been in the process of change since the Merci retriever and Penumbra system as mechanical thrombectomy devices were approved in 2010 and 2011, and the therapeutic time window of IV t-PA was extended from 3 hours to 4.5 hours in 2012. The authors discussed on new evidences and future prospects of hyperacute recanalization therapy and acute antithrombotic therapy, bringing about a revolution to routine clinical practice in Japan.