Plasminogen activation and thrombolysis for ischemic stroke.

Abstract

The plasminogen-activating enzyme system has been exploited and harnessed for therapeutic thrombolysis for nearly three decades. Tissue-type plasminogen activator is still the only thrombolytic agent approved for patients with ischemic stroke. While tissue-type plasminogen activator-induced thrombolysis is proven to be of clear benefit in these patients if administered within 4·5 h poststroke onset, it is surprisingly underused in clinics despite international guidelines and improved acute stroke systems, a situation that requires urgent attention. While tissue-type plasminogen activator has also been shown to have unforeseen roles in the brain that have presented new challenges, tissue-type plasminogen activator and related fibrinolytic agents are currently being assessed over extended time frames. This review will focus on the therapeutic experience and controversies of tissue-type plasminogen activator. Furthermore, we will also provide an overview of recent and current trials assessing tissue-type plasminogen activator and related thrombolytic agents as well as novel approaches for the treatment of ischemic stroke.

• Authors: Robert L Medcalf, Stephen M Davis
• Journal: International journal of stroke : official journal of the International Stroke Society (Int J Stroke) Vol. 7 Issue 5 Pg. 419-25 (Jul 2012) ISSN: 1747-4949 [Electronic] United States
• PMID: 22463085 (Publication Type: Journal Article, Review)
• Copyright: © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator

Topics

• Animals
• Brain (metabolism)
• Brain Ischemia (drug therapy)
• Clinical Trials as Topic
• Disease Models, Animal
• Fibrinolysis (physiology)
• Fibrinolytic Agents (pharmacology, therapeutic use)
• Humans
• Infusions, Intravenous
• Meta-Analysis as Topic
• Mice
• Stroke (drug therapy)
• Thrombolytic Therapy (methods)
• Tissue Plasminogen Activator (metabolism, pharmacology, therapeutic use)