The March of Thrombolytic Therapy for Acute Ischemic Stroke to Clinical Trials: Pre-clinical Thrombolysis and Adjuncts to Thrombolysis Research

Data from experimental and clinical cerebral ischemia studies demonstrate that acute stroke must be treated within a few hours or less to effectively reduce stroke morbidity and mortality. Time from symptom onset (presumed time of acute cerebral arterial occlusion) to treatment initiation is considered the single most important factor in the effective treatment of acute focal cerebral ischemia/infarction. Recently the time window for use of tissue plasminogin activator (rt-PA), the only approved thrombolytic pharmacotherapy for acute stroke intervention, has been extended from 3 to 4.5 h. Hemorrhagic conversion can occur and limits it use beyond this time and the efficacy drops off considerably as well.