Advances in the Treatment of Ischemic Stroke: A Narrative Review of Acute Therapies, Neuroprotection and Technological Innovations

• DOI: https://doi.org/10.22533/at.ed.15941042413128

• Palavras-chave: ischemic stroke, thrombolysis, mechanical thrombectomy, neuroprotection.

• Keywords: ischemic stroke, thrombolysis, mechanical thrombectomy, neuroprotection.

• Abstract:

  Ischemic stroke is one of the leading causes of morbidity and mortality worldwide, requiring constant advances in its clinical management. This article reviews recent advances in acute therapies, neuroprotective strategies and technological innovations applied to the treatment of ischemic stroke. Intravenous thrombolysis with alteplase and mechanical thrombectomy remain mainstays of treatment, with the emergence of alternatives such as tenecteplase and combined interventions, such as intra-arterial administration of alteplase after thrombectomy, broadening the therapeutic possibilities. Neuroprotective strategies, including antioxidants, ferroptosis modulators and inhibitors of inflammatory processes, show significant potential for mitigating the secondary damage caused by ischemia.
  Innovations such as nanotechnology, extracellular vesicles and artificial intelligence are redefining diagnosis and treatment, while cell therapies and remote ischemic conditioning are emerging as promising complementary approaches. Despite the advances, challenges remain in translating preclinical discoveries into the clinical context, accessibility to technologies and identification of subgroups benefiting from personalized treatments. The integration of vascular recanalization, neuroprotection and tissue regeneration represents a promising integrative approach with the potential to significantly improve the clinical outcomes of ischemic stroke patients. Future studies should validate these therapies in robust clinical trials, contributing to advances in the care of this devastating condition.