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Experimental treatments for acute ischaemic stroke. |
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Experimental treatments for acute ischaemic stroke.
Lancet. 2007 Jan 27;369(9558):331-41.
Sacco RL, Chong JY, Prabhakaran S, Elkind MS.
Department of Neurology, College of Physicians and Surgeons Columbia University, New York, NY, USA.
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Treatments
for acute ischaemic stroke continue to evolve. Experimental approaches
to restore cerebral perfusion include techniques to augment
recanalising therapies, including combination of antiplatelet agents
with intravenous thrombolysis, bridging therapy of combining
intravenous with intra-arterial thrombolysis, and trials of new
thrombolytic agents.
Trials with MRI selection criteria are underway to
expand the window of opportunity for thrombolysis. Sonothrombolysis and
novel endovascular mechanical devices to retrieve or dissolve acute
cerebral occlusions are being tested. Approaches to improve cerebral
perfusion with other devices and induced hypertension are also being
considered. Although numerous neuroprotective agents have not shown
benefit, trials of hypothermia, magnesium, caffeinol, high doses of
statins, and albumin are continuing. The findings of these randomised
trials are anticipated to allow improved treatment of patients with
acute stroke.
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