The major aim of acute stroke treatment is to save the hypoperfused cerebral parenchyma in order to minimize residual disability. Early recanalization of occluded arteries with thrombolytic therapy is the most efficient procedure for protecting the brain parenchyma which is not yet infarcted.
Intravenous administration of Alteplase (recombinant tissue-type plasminogen activator – rtPA) has proven to be effective in reducing disability at 90 and 180 days after stroke in patients treated within 4.5 hours from symptoms onset.
Recently, striking results have been provided by the endovascular treatment, unless in a selected population. The use of the stent-retrievers or direct thrombus aspiration is now a good option for acute stroke treatment giving the opportunity of an effective multimodal therapeutic approach.