The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
Update on Treatment of Acute Ischemic Stroke
Abstract
EDITOR'S NOTE: The article "Update on Treatment of Acute Ischemic Stroke" by Dr Rabinstein was first published in the February 2017 Cerebrovascular Disease issue of Continuum: Lifelong Learning in Neurology as "Treatment of Acute Ischemic Stroke" and has been updated by Dr Rabinstein for this issue at the request of the Editor-in-Chief. ABSTRACT: PURPOSE OF REVIEWThis article provides an update on the state of the art of the treatment of acute ischemic stroke with particular emphasis on the indications for reperfusion therapy.RECENT FINDINGSIn addition to the previously established indications for intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rtPA) within 4.5 hours of stroke symptom onset and endovascular therapy with mechanical thrombectomy for patients with large artery occlusion who can be treated within 6 hours of symptom onset, recent randomized controlled trials have now established new indications for emergency reperfusion in patients with wake-up stroke or delayed presentation (up to 24 hours from last known well in the case of mechanical thrombectomy). Identification of patients who may benefit from acute reperfusion therapy within this extended time window requires screening with perfusion brain imaging or, in the case of IV thrombolysis for wake-up strokes, emergency brain MRI. Collateral status and time to reperfusion remain the primary determinants of outcome.SUMMARYTimely successful reperfusion is the most effective treatment for patients with acute ischemic stroke. Recent evidence supports the expansion of the time window for reperfusion treatment in carefully selected patients.
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Cites
Tissue Plasminogen Activator for Acute Ischemic Stroke
(1995) · New England Journal of Medicine · doi:10.1056/nejm199512143332401 · Cited by 11,654
Goyal, M., Menon, B. K., van Zwam, W. H., Dippel, D. W. J., Mitchell, P. J., Demchuk, A. M., Dávalos, A., Majoie, C. B. L. M., van der Lugt, A., de Miquel, M. A., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00163-x · Cited by 7,815
Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., et al. (2019) · Stroke · doi:10.1161/str.0000000000000211 · Cited by 7,468
Self-citationThrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke
Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Dávalos, A., Guidetti, D., Larrue, V., Lees, K. R., Medeghri, Z., Machnig, T., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0804656 · Cited by 6,684
A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Berkhemer, O. A., Fransen, P. S. S., Beumer, D., van den Berg, L. A., Lingsma, H. F., Yoo, A. J., Schonewille, W. J., Vos, J. A., Nederkoorn, P. J., Wermer, M. J. H., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1411587 · Cited by 6,657
Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke
Goyal, M., Demchuk, A. M., Menon, B. K., Eesa, M., Rempel, J. L., Thornton, J., Roy, D., Jovin, T. G., Willinsky, R. A., Sapkota, B. L., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1414905 · Cited by 6,083
Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection
Campbell, B. C. V., Mitchell, P. J., Kleinig, T. J., Dewey, H. M., Churilov, L., Yassi, N., Yan, B., Dowling, R. J., Parsons, M. W., Oxley, T. J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1414792 · Cited by 5,819
Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct
Nogueira, R. G., Jadhav, A. P., Haussen, D. C., Bonafe, A., Budzik, R. F., Bhuva, P., Yavagal, D. R., Ribo, M., Cognard, C., Hanel, R. A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1706442 · Cited by 5,629
Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke
Saver, J. L., Goyal, M., Bonafe, A., Diener, H.-C., Levy, E. I., Pereira, V. M., Albers, G. W., Cognard, C., Cohen, D. J., Hacke, W., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1415061 · Cited by 5,193
Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging
Albers, G. W., Marks, M. P., Kemp, S., Christensen, S., Tsai, J. P., Ortega-Gutierrez, S., McTaggart, R. A., Torbey, M. T., Kim-Tenser, M., Leslie-Mazwi, T., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1713973 · Cited by 4,930
Cited by
Mwale, P. F., Hsieh, C.-T., Yen, T.-L., Jan, J.-S., Taliyan, R., Yang, C.-H., & Yang, W.-B. (2025) · Molecular Neurodegeneration · doi:10.1186/s13024-025-00801-8 · Cited by 47
Metadata
- Authors
- Rabinstein, A. A.
- Venue
- Continuum
- Published
- 2020-04
- Volume
- 26
- Issue
- 2
- Pages
- 268-286
- ISSN
- 1080-2371 (ISSN-L)
- 1538-6899
- OpenAlex
- W3013734627
- Cited by
- 293
- References
- 46
- FWCI
- 24.88
- Type
- journal article
- Language
- en
- Open access
- closed
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