Advancements in the management of acute ischemic stroke: A narrative review
Abstract Primary literature detailing updated management principles of acute ischemic stroke outpaces current guidelines, resulting in heterogenous practices. Recent advancements in neuroimaging have shifted treatment from a time‐based approach to an individualized, image‐guided appraisal directed b...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12896 |
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| author | Blake T. Robbins Gavin T. Howington Kara Swafford Jaryd Zummer Jordan A. Woolum |
| author_facet | Blake T. Robbins Gavin T. Howington Kara Swafford Jaryd Zummer Jordan A. Woolum |
| author_sort | Blake T. Robbins |
| collection | DOAJ |
| description | Abstract Primary literature detailing updated management principles of acute ischemic stroke outpaces current guidelines, resulting in heterogenous practices. Recent advancements in neuroimaging have shifted treatment from a time‐based approach to an individualized, image‐guided appraisal directed by the presence or absence of salvageable brain tissue. In addition, tenecteplase appears to be a safe and effective for the treatment of acute ischemic stroke and is becoming an attractive agent due to its practical administration. Several factors must be accounted for when implementing tenecteplase into the health‐system including cost, education, and changes in clinician workflows. Larger studies with broad patient populations are needed to more definitively evaluate whether intravenous thrombolytics should be used in combination with endovascular thrombectomy in patients with anterior large‐vessel occlusions. Although debate regarding the safety and efficacy of various endovascular therapies, delays encountered in the identification, triage, and care of acute ischemic stroke patients increase the likelihood of necrotic core lesion development and loss of salvageable penumbra. |
| format | Article |
| id | doaj-art-d31fb86c832447f6a7bdde089f97d2f7 |
| institution | Kabale University |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-d31fb86c832447f6a7bdde089f97d2f72025-08-20T03:24:07ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-02-0141n/an/a10.1002/emp2.12896Advancements in the management of acute ischemic stroke: A narrative reviewBlake T. Robbins0Gavin T. Howington1Kara Swafford2Jaryd Zummer3Jordan A. Woolum4Department of Pharmacy University of Kentucky HealthCare Lexington Kentucky USADepartment of Pharmacy University of Kentucky HealthCare Lexington Kentucky USADepartment of Neurology University of Kentucky HealthCare Lexington Kentucky USADepartment of Emergency Medicine University of Kentucky HealthCare Lexington Kentucky USADepartment of Pharmacy University of Kentucky HealthCare Lexington Kentucky USAAbstract Primary literature detailing updated management principles of acute ischemic stroke outpaces current guidelines, resulting in heterogenous practices. Recent advancements in neuroimaging have shifted treatment from a time‐based approach to an individualized, image‐guided appraisal directed by the presence or absence of salvageable brain tissue. In addition, tenecteplase appears to be a safe and effective for the treatment of acute ischemic stroke and is becoming an attractive agent due to its practical administration. Several factors must be accounted for when implementing tenecteplase into the health‐system including cost, education, and changes in clinician workflows. Larger studies with broad patient populations are needed to more definitively evaluate whether intravenous thrombolytics should be used in combination with endovascular thrombectomy in patients with anterior large‐vessel occlusions. Although debate regarding the safety and efficacy of various endovascular therapies, delays encountered in the identification, triage, and care of acute ischemic stroke patients increase the likelihood of necrotic core lesion development and loss of salvageable penumbra.https://doi.org/10.1002/emp2.12896acute ischemic strokefibrinolyticsneuroimagingtenecteplasethrombectomy |
| spellingShingle | Blake T. Robbins Gavin T. Howington Kara Swafford Jaryd Zummer Jordan A. Woolum Advancements in the management of acute ischemic stroke: A narrative review Journal of the American College of Emergency Physicians Open acute ischemic stroke fibrinolytics neuroimaging tenecteplase thrombectomy |
| title | Advancements in the management of acute ischemic stroke: A narrative review |
| title_full | Advancements in the management of acute ischemic stroke: A narrative review |
| title_fullStr | Advancements in the management of acute ischemic stroke: A narrative review |
| title_full_unstemmed | Advancements in the management of acute ischemic stroke: A narrative review |
| title_short | Advancements in the management of acute ischemic stroke: A narrative review |
| title_sort | advancements in the management of acute ischemic stroke a narrative review |
| topic | acute ischemic stroke fibrinolytics neuroimaging tenecteplase thrombectomy |
| url | https://doi.org/10.1002/emp2.12896 |
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