ABSTRACT
An underlying cause of the majority of cerebral strokes is chronic vascular pathology. Nevertheless, an overwhelming therapeutic development effort so far has focused on targeting brain parenchymal cells to achieve neuroprotection and/or repair. The vessel-protecting strategies have only begun to emerge, driven by the need to extend the therapeutic window for thrombolytic therapy. The goals of these vasculoprotective therapies are to mitigate detrimental effects of thrombolytic therapy on brain vessel and blood-brain barrier (BBB) integrity and to reduce the risk of hemorrhagic complications. This chapter will summarize pre-clinical and clinical studies on the mechanisms of vascular damage caused by the tissue plasminogen activator (tPA), as well as emerging strategies to protect and repair brain vessels as a potential therapeutic approach.
