NEW INTERVENTIONS IN CEREBROVASCULAR-DISEASE - THE ROLE OF THROMBOLYTIC THERAPY AND BALLOON ANGIOPLASTY

The use of thrombolytic agents (plasminogen activators) in the early m oments of ischemic stroke to achieve recanalization and potential neur ologic improvement has been actively studied over the past 10 years. I n the same period, endovascular techniques for cerebral revascularizat ion have evolved significantly. Recent phase III studies, following an giography-based phase I and II studies of plasminogen activators in st roke, have described evidence of clinical benefit and contributors to morbidity (ie, symptomatic hemorrhage) and mortality that limit the ap plicability of this approach. The limited formalized experience with p ercutaneous transluminal balloon angioplasty and stent placement in th e carotid artery and cerebral circulation has given rise to concerns a bout the safety and appropriateness of the procedures in this territor y. However, several prospective series support the feasibility of well -designed clinical trials.