Precision Medicine for Ischemic Stroke, Let Us Move Beyond Time Is Brain

Excerpt

Until 1995, treatment of ischemic stroke consisted exclusively of efforts to prevent recurrence. Since that time, the introduction of recombinant tissue plasminogen activator (rtPA) treatment has significantly improved morbidity and mortality of ischemic stroke [1]. Ischemic stroke is treatable but time is critical. The term “time is brain” has been coined for acute stroke intervention, even before the rtPA trials, to emphasize that the human brain is rapidly and irreversibly lost as stroke progresses and that therapeutic interventions should be emergently pursued [2‐5]. Two decades after the approval of intravenous rtPA for the treatment of ischemic stroke, interventions to reopen an occluded artery through thrombolysis and mechanical thrombectomy remain the only and first priority in ischemic stroke treatment. Accordingly, dramatic effort has been investing to reduce the time from stroke onset to treatment and arrival-to-puncture time for ischemic stroke patients. It is anticipated that an interdisciplinary and rapid response to the emergence of stroke intervention can result in dramatic impact of thrombolysis on this public health problem. Unfortunately, the number of ischemic stroke patients who are treated with thrombolytic therapy is still disappointingly low. …