ISC 2025 | The future of thrombolytic therapy for medium vessel occlusion stroke
Aristeidis Katsanos, MD, McMaster University, Hamilton, Ontario, Canada, discusses the future of thrombolytic therapy for acute ischemic stroke, particularly medium vessel occlusions. Dr Katsanos notes that research is moving in two directions, one focusing on expanding the time window for thrombolysis and the other on developing more effective and safer thrombolytic agents. This interview took place at the 2025 International Stroke Conference (ISC), held in Los Angeles, CA.
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Transcript
One of the biggest kind of like knowledge that we got from ISC was that endovascular thrombectomy is not effective and probably not safe for patients with MeVos, right? So this opens up a big avenue for the use of thrombolytic agents to improve patient outcomes. So from what I see is that thrombolytic agent research is moving into two different directions. One is to expand the window for thrombolysis...
One of the biggest kind of like knowledge that we got from ISC was that endovascular thrombectomy is not effective and probably not safe for patients with MeVos, right? So this opens up a big avenue for the use of thrombolytic agents to improve patient outcomes. So from what I see is that thrombolytic agent research is moving into two different directions. One is to expand the window for thrombolysis. So now we have evidence, robust evidence up to 4.5 hours and evidence also from trials that we can go up to nine hours. There are studies that they presented also during ISC that we can expand even thrombolysis up to 24 hours by using some advanced imaging. So that’s the one direction that the research is moving. And the other one is to develop more efficacious and more safe thrombolytic agents. So there is a lot of research going on in multiple different directions, testing multiple different agents. And I’m hopeful that in the next 4-5 years, maybe even sooner than that, we’ll have some new evidence from trials and hopefully new thrombolytics that can improve our patient outcomes.
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