Current acute stroke trials and their potential impact on the therapeutic time window

Abstract

Several trials in acute stroke are underway or have been completed recently. Among the latter, ECASS 3 was a milestone regarding the extension of the rigid 3-h time window out to 4.5 h for intravenous thrombolysis with recombinant tissue plasminogen activator. Several other approaches are being tested for thrombolytic therapy, among them modern imaging-based patient selection of patients and interventional approaches. Other pharmaceutical strategies include neuroprotection, and restoration, biophysical approaches, such as near infrared laser therapy, hemodynamic augmentation, and sphenopalatine ganglion stimulation. This perspective will cover the recently completed and currently recruiting acute stroke trials with respect to their potential role in expanding the therapeutic time window for acute ischemic stroke.

Keywords::

• citicoline
• G-CSF
• hemodynamic augmentation
• intra-arterial thrombolysis
• intravenous thrombolysis
• near-infrared laser therapy
• NeuroFlo
• rt-PA
• sphenopalatine ganglion stimulation
• stroke MRI
• thrombectomy devices

Financial & competing interests disclosure

PD Schellinger has received honoraria, advisory board and travel grants. He has been on the speaker board for Boehringer Ingelheim, Coaxia Inc., Photothera, Sanofi, Ferrer, ev3/covidien and GSK. M Köhrmann has received honoraria, advisory board and travel grants. He has been on the speaker board for Boehringer Ingelheim, Coaxia Inc., Photothera. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.