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Reperfusion for acute ischemic stroke: arterial revascularization and collateral therapeutics

Liebeskind, David S

doi: 10.1097/WCO.0b013e328334da32
Cerebrovascular disease: Edited by Patrik Michel

Purpose of review Reperfusion of the ischemic territory forms the basis of most acute stroke treatments. This overview of the literature relating to reperfusion in acute ischemic stroke published within the last year provides a snapshot of a rapidly evolving aspect of cerebrovascular disease.

Recent findings Arterial revascularization from systemic thrombolysis to combination endovascular procedures to achieve recanalization has proliferated. Stroke imaging continues to discern features of critical pathophysiology that may influence tissue fate and clinical outcome. Balancing the risk of hemorrhagic transformation against the therapeutic aim to salvage the ischemic penumbra remains a formidable challenge. Collateral therapeutics that enhance perfusion outside the ischemic core present novel dimension to acute stroke therapy, focused on ischemia and not just the clot or plaque.

Summary These timely findings illustrate the essential role of reperfusion in acute stroke, delineating aspects of arterial revascularization and collateral therapeutics to be refined in coming years.

UCLA Stroke Center, Los Angeles, California, USA

Correspondence to David S. Liebeskind, MD, UCLA Stroke Center, 710 Westwood Plaza, Los Angeles, CA 90095, USA Tel: +1 310 794 6379; fax: +1 310 267 2063; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.