TY - JOUR
T1 - Acute ischemic stroke management
T2 - Concepts and Controversies. A narrative review
AU - Li, Ka Hou Christien
AU - Jesuthasan, Aaron
AU - Kui, Christopher
AU - Davies, Ruth
AU - Tse, Gary
AU - Lip, Gregory Y H
PY - 2021
Y1 - 2021
N2 - INTRODUCTION: Amongst the 25.7 million survivors and 6.5 million deaths from stroke between 1990 and 2013, ischemic strokes accounted for approximately 70% and 50% of the cases, respectively. With patients still suffering from complications and stroke recurrence, more questions have been raised as to how we can better improve patient management.AREAS COVERED: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Newcastle-Ottawa Scale (NOS) were adopted to ensure a comprehensive inclusion of quality literature from various sources. PubMed and Embase were searched for evidence on thrombolysis, mechanical thrombectomy, artificial intelligence (AI), antiplatelet therapy, anticoagulation and hypertension management.EXPERT OPINION: The directions of future research in these areas are dependent on the current level of validation. Endovascular therapy and applications of AI are relatively new compared to the other areas discussed in this review. As such, future studies need to focus on validating their efficacy. As for thrombolysis, antiplatelet and anticoagulation therapy, their efficacy has been well-established and future research efforts should be directed toward adjusting its use according to patient-specific factors, starting with factors with the most clinical relevance and prevalence.
AB - INTRODUCTION: Amongst the 25.7 million survivors and 6.5 million deaths from stroke between 1990 and 2013, ischemic strokes accounted for approximately 70% and 50% of the cases, respectively. With patients still suffering from complications and stroke recurrence, more questions have been raised as to how we can better improve patient management.AREAS COVERED: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Newcastle-Ottawa Scale (NOS) were adopted to ensure a comprehensive inclusion of quality literature from various sources. PubMed and Embase were searched for evidence on thrombolysis, mechanical thrombectomy, artificial intelligence (AI), antiplatelet therapy, anticoagulation and hypertension management.EXPERT OPINION: The directions of future research in these areas are dependent on the current level of validation. Endovascular therapy and applications of AI are relatively new compared to the other areas discussed in this review. As such, future studies need to focus on validating their efficacy. As for thrombolysis, antiplatelet and anticoagulation therapy, their efficacy has been well-established and future research efforts should be directed toward adjusting its use according to patient-specific factors, starting with factors with the most clinical relevance and prevalence.
KW - Stroke
KW - anticoagulation
KW - antiplatelet
KW - artificial intelligence
KW - thrombectomy
KW - thrombolysis
UR - http://www.scopus.com/inward/record.url?scp=85095780938&partnerID=8YFLogxK
U2 - 10.1080/14737175.2021.1836963
DO - 10.1080/14737175.2021.1836963
M3 - Review article
C2 - 33047640
SN - 1473-7175
VL - 21
SP - 65
EP - 79
JO - Expert Review of Neurotherapeutics
JF - Expert Review of Neurotherapeutics
IS - 1
ER -