Vascular and non-vascular approaches to the treatment of stroke

Abstract

Stroke is the third leading cause of death in the Western world and a major burden on healthcare systems. Current treatment is primarily limited to anticoagulant or antiplatelet therapy for primary or secondary prevention of stroke. A small number of ischaemic stroke patients are eligible for thrombolytic therapy with tissue plasminogen activator (t-PA) but this has to be administered within 3 hours of the ischaemic event. A large number of agents are currently under development for stroke. Recently, a number of new compounds have failed to show positive effects in Phase III trials in ischaemic stroke. In many cases the reasons for this are not clear; however, some could have been predicted. However, much has been learnt about the design and implementation of clinical trials for neuroprotective agents as a consequence of these studies.