ABSTRACT
Stroke is the third most common cause of death in the industrialized nations, after myocardial infarction and cancer, and the single most common reason for permanent disability.1 Up to 85% of all strokes are of ischaemic origin and mostly due to blockage of a cerebral artery by a blood clot.2 After introduction of thrombolytic therapy for the treatment of acute myocardial infarction in the early 1990s, major trials for the evaluation of this new therapeutic approach to ischaemic stroke were initiated.3
Occlusion of a brain vessel leads to a critical reduction in cerebral perfusion and, within minutes, to ischaemic infarction with a central infarct core of irreversibly damaged brain tissue with an area of surrounding critical hypoperfusion of varying size (the ischaemic penumbra), which can be salvaged by rapid restoration of blood flow.4,5 Therefore, the underlying rationale for the introduction and application of thrombolytic agents is the lysis of an obliterating thrombus and subsequent re-establishment of cerebral blood flow by cerebrovascular recanalization.6
