So if they have solved the failures of 1000+ neuroprotective trials, then every single stroke hospital needs the protocols.
Well, years ago Dr. Michael Tymianski of the Toronto Western Hospital Research Institute
in Canada referenced 1000+ failed neuroprotective clinical trials. Of
course nobody knows of them and what knowledge they provided, but your doctor should know every one
of those failed trials.
The Next Step in the Treatment of Stroke
Nathanael Matei 1
, Justin Camara2 and John H. Zhang2,3,4
*
1 Department of Ophthalmology, University of Southern California, Los Angeles, CA, United States, 2 Department of
Physiology and Pharmacology, Loma Linda University, Loma Linda, CA, United States, 3 Department of Anesthesiology,
Loma Linda University, Loma Linda, CA, United States, 4 Department of Neurosurgery, Loma Linda University, Loma Linda,
CA, United States
Although many patients do not receive reperfusion therapy because of delayed
presentation and/or severity and location of infarct, new reperfusion approaches are
expanding the window of intervention. Novel application of neuroprotective agents
in combination with the latest methods of reperfusion provide a path to improved
stroke intervention outcomes. We examine why neuroprotective agents have failed to
translate to the clinic and provide suggestions for new approaches. New developments
in recanalization therapy in combination with therapeutics evaluated in parallel animal
models of disease will allow for novel, intra-arterial deployment of therapeutic agents over
a vastly expanded therapeutic time window and with greater likelihood success. Although
the field of neuronal, endothelial, and glial protective therapies has seen numerous large
trials, the application of therapies in the context of newly developed reperfusion strategies
is still in its infancy. Given modern imaging developments, evaluation of the penumbra
will likely play a larger role in the evolving management of stroke. Increasingly more
patients will be screened with neuroimaging to identify patients with adequate collateral
blood supply allowing for delayed rescue of the penumbra. These patients will be ideal
candidates for therapies such as reperfusion dependent therapeutic agents that pair
optimally with cutting-edge reperfusion techniques
, Justin Camara2 and John H. Zhang2,3,4
*
1 Department of Ophthalmology, University of Southern California, Los Angeles, CA, United States, 2 Department of
Physiology and Pharmacology, Loma Linda University, Loma Linda, CA, United States, 3 Department of Anesthesiology,
Loma Linda University, Loma Linda, CA, United States, 4 Department of Neurosurgery, Loma Linda University, Loma Linda,
CA, United States
Although many patients do not receive reperfusion therapy because of delayed
presentation and/or severity and location of infarct, new reperfusion approaches are
expanding the window of intervention. Novel application of neuroprotective agents
in combination with the latest methods of reperfusion provide a path to improved
stroke intervention outcomes. We examine why neuroprotective agents have failed to
translate to the clinic and provide suggestions for new approaches. New developments
in recanalization therapy in combination with therapeutics evaluated in parallel animal
models of disease will allow for novel, intra-arterial deployment of therapeutic agents over
a vastly expanded therapeutic time window and with greater likelihood success. Although
the field of neuronal, endothelial, and glial protective therapies has seen numerous large
trials, the application of therapies in the context of newly developed reperfusion strategies
is still in its infancy. Given modern imaging developments, evaluation of the penumbra
will likely play a larger role in the evolving management of stroke. Increasingly more
patients will be screened with neuroimaging to identify patients with adequate collateral
blood supply allowing for delayed rescue of the penumbra. These patients will be ideal
candidates for therapies such as reperfusion dependent therapeutic agents that pair
optimally with cutting-edge reperfusion techniques
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