American Society of Hirudotherapy

Treatment of acute ischemic stroke: recent progress

Review published in Internal medicine (Tokyo, Japan) (2002)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical LiteratureTanahashi et al. · Internal medicine (Tokyo, Japan), 2002

Abstract

Intravenous thrombolysis with tissue plasminogen activator is currently the most effective treatment of acute ischemic stroke if administerd within 3 hours after symptom onset. Intraarterial thrombolysis by prourokinase is the another choise if the middle cerebral artery is occluded and within less than 6 hours after onset. Although heparin especially a moderate dose is not proved to be effective, a randomized, placebo-controlled trial to determine the safety and efficacy of argatroban (a selective thrombin inhibitor) in patients with acute ischemic stroke was started in USA. Aspirin provides some benefit to patients with acute stroke. However, its effect is not fully satisfactory. Although reports of numerous trials for neuroprotective drugs have been disappointing, edaravone (free radical scavenger) was approved for the treatment of acute ischemic stroke in Japan. In the future, thrombolytic and neuroprotective drugs will be used in combination.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsClinical Trials as TopicFibrinolytic AgentsHumansNeuroprotective AgentsStrokeThrombolytic Therapy

Summary

Review of acute ischemic stroke therapy: intravenous tissue plasminogen activator within 3 hours remains most effective, intra-arterial prourokinase is an option for middle cerebral artery occlusion within 6 hours, and a US argatroban trial plus edaravone approval mark progress in anticoagulant and neuroprotective approaches.

Context

This review summarizes recent progress in the treatment of acute ischemic stroke, discussing intravenous tissue plasminogen activator within 3 hours of onset, intra-arterial prourokinase for middle cerebral artery occlusion, aspirin, the free radical scavenger edaravone approved in Japan, and a trial of argatroban that was started in the USA. The article mentions argatroban as a selective thrombin inhibitor being investigated for acute stroke, but does not discuss hirudin, leeches, or any leech-derived compound. Argatroban is a synthetic agent.

Citation

Reference (Vancouver style)

Tanahashi N, Fukuuchi Y. Treatment of acute ischemic stroke: recent progress. Intern Med. 2002;41(5):337-344. doi:10.2169/internalmedicine.41.337. PMID: 12058880

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

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