Beyond recanalization — a call for action in acute stroke


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Despite the strong treatment effects of mechanical thrombectomy in acute ischaemic stroke, penumbral tissue loss before recanalization and ischaemia–reperfusion injury after diminish


functional outcomes and call for adjunct treatments. Classical neuroprotection strategies could consequently be revived, but novel treatment targets are also emerging through mechanistic


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taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Goyal, M. et


al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. _Lancet_ 387, 1723–1731 (2016). Article  Google


Scholar  * Jung, S. et al. Factors that determine penumbral tissue loss in acute ischaemic stroke. _Brain_ 136, 3554–3560 (2013). Article  Google Scholar  * Hill, M. D. et al. Efficacy and


safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. _Lancet_ 395, 878–877 (2020). Article  CAS  Google


Scholar  * Shuaib, A. et al. Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target. _Lancet Neurol._ 10, 909–921 (2011). Article  Google Scholar  * Baron, J. C.


Protecting the ischaemic penumbra as an adjunct to thrombectomy for acute stroke. _Nat. Rev. Neurol._ 14, 325–337 (2018). Article  CAS  Google Scholar  * Pham, M. & Bendszus, M. Facing


time in ischemic stroke: an alternative hypothesis for collateral failure. _Clin. Neuroradiol._ 26, 141–151 (2016). Article  CAS  Google Scholar  * Desilles, J. P. et al. Downstream


microvascular thrombosis in cortical venules is an early response to proximal cerebral arterial occlusion. _J. Am. Heart. Assoc._ 7, e007804 (2018). Article  Google Scholar  * Kollikowski,


A. et al. Local leukocyte invasion during hyperacute human ischaemic stroke. _Ann. Neurol._ 87, 466–479 (2020). Article  CAS  Google Scholar  * Schuhmann, M. K. et al. CD84 links T cell and


platelet activity in cerebral thrombo-inflammation in acute stroke. _Circ. Res._ https://doi.org/10.1161/CIRCRESAHA.120.316655 (2020). Article  PubMed  PubMed Central  Google Scholar  *


Stoll, G. & Nieswandt, B. Thrombo-inflammation in acute ischaemic stroke - implications for treatment. _Nat. Rev. Neurol._ 15, 473–481 (2019). Article  CAS  Google Scholar  Download


references ACKNOWLEDGEMENTS Work cited in this comment was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Projektnummer 374031971 –TRR 240. AUTHOR


INFORMATION AUTHORS AND AFFILIATIONS * Department of Neurology, Würzburg University Hospital, Würzburg, Germany Guido Stoll * Department of Neuroradiology, Würzburg University Hospital,


Würzburg, Germany Mirko Pham Authors * Guido Stoll View author publications You can also search for this author inPubMed Google Scholar * Mirko Pham View author publications You can also


search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Guido Stoll. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. RIGHTS


AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Stoll, G., Pham, M. Beyond recanalization — a call for action in acute stroke. _Nat Rev Neurol_ 16, 591–592


(2020). https://doi.org/10.1038/s41582-020-00417-0 Download citation * Published: 23 September 2020 * Issue Date: November 2020 * DOI: https://doi.org/10.1038/s41582-020-00417-0 SHARE THIS


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