Literature Review: Thrombolysis In Patients With Acute Ischemic Stroke

Abstract

Stroke is one of the leading causes of morbidity and mortality worldwide, with ischemic stroke being the most common type. Ischemic stroke occurs due to obstruction of blood flow to brain tissue, resulting in ischemia, hypoxia, and potentially irreversible brain tissue damage if not treated promptly and appropriately. In the acute phase, the primary principle of management is to restore blood flow to hypoperfused areas of the brain as quickly as possible in order to preserve viable brain tissue, particularly the ischemic penumbra. One of the main reperfusion modalities is thrombolytic therapy, which aims to lyse intravascular thrombi and restore cerebral blood flow. Although thrombolytic therapy provides benefits in improving functional outcomes, it carries a risk of complications, particularly intracranial hemorrhage; therefore, appropriate patient selection, imaging evaluation, and monitoring are required. This final assignment uses a literature review method by examining various sources that discuss thrombolytic therapy in patients with acute ischemic stroke. The literature reviewed covers ischemic stroke, the mechanism of action of thrombolytic agents, methods of administration, inclusion and exclusion criteria, intravenous and intra-arterial thrombolysis, mechanical thrombectomy, types of thrombolytic agents, imaging prior to thrombolysis, as well as complications and therapeutic monitoring. Relevant literature was subsequently reviewed and descriptively organized to provide a comprehensive overview of the role of thrombolysis in the management of acute ischemic stroke. Based on the literature review, thrombolysis plays a role in restoring cerebral blood flow through thrombus lysis. Intravenous alteplase is one of the main therapies that provides optimal benefits when administered as early as possible to patients who meet the appropriate criteria. Patient selection, brain imaging, and monitoring are necessary to reduce the risk of complications, particularly intracranial hemorrhage. Thrombolysis is an important reperfusion therapy for acute ischemic stroke. Prompt and appropriate administration in patients who meet the criteria can improve functional outcomes, while taking into consideration the risk of bleeding and the need for close monitoring.