Future aspect in management of acute ischemic stroke

Abstract

Therapeutic approach for acute cerebral ischemia has made great progress in thrombolysis and endovascular approach. In the clinical field, emergent system for acute stroke patients to provide such therapy needs to be rearranged not only in the town but also in the rural area in Japan. However, more than half of patients who suffered acute stroke still need some help in daily life. For future aspect of acute stroke therapy, several promising strategies includes development of novel tissue plasminogen activator, anti–platelet drug, neuroprotective drug, cell therapy and remote limb ischemic conditioning. Collateral circulation is a key factor for determining ischemic severity in the acute stage. Remote ischemic limb condition might show brain protective effect through enhancement of collateral circulation.