Clinical trials in stroke intervention during the past year have yielded contrasting results. Endovascular therapies and procedures to reduce stroke risk caused by patent foramen ovale have failed to demonstrate superiority over standard medical treatments. By contrast, a trial of neuroprotection—traditionally thought to be ineffective in humans—offers hope.
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References
Broderick, J. P. et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N. Engl. J. Med. 368, 893–903 (2013).
Ciccone, A. et al. Endovascular treatment for acute ischemic stroke. N. Engl. J. Med. 368, 904–913 (2013).
Kidwell, C. S. et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N. Engl. J. Med. 368, 914–923 (2013).
Carroll, J. D. et al. Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. N. Engl. J. Med. 368, 1092–1100 (2013).
Meier, B. et al. Percutaneous closure of patent foramen ovale in cryptogenic embolism. N. Engl. J. Med. 368, 1083–1091 (2013).
Hill, M. D. et al. Safety and efficacy of NA-1 in patients with iatrogenic stroke after endovascular aneurysm repair (ENACT): a phase 2, randomised, double-blind, placebo-controlled trial. Lancet Neurol. 11, 942–950 (2012).
Rha, J. H. & Saver, J. L. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke 3, 967–973 (2007).
Cook, D. J., Teves, L. & Tymianski, M. Treatment of stroke with a PSD-95 inhibitor in the gyrencephalic primate brain. Nature 483, 213–217 (2012).
Furlan, A. J. et al. Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N. Engl. J. Med. 366, 991–999 (2012).
O'Collins, V. E. et al. 1,026 experimental treatments in acute stroke. Ann. Neurol. 59, 467–477 (2006).
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M. Tymianski is president of NoNO Inc., a biotechnology company founded to develop PSD95 inhibitors discovered in his research laboratory.
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Tymianski, M. Disappointments and advances in acute stroke intervention. Nat Rev Neurol 10, 66–68 (2014). https://doi.org/10.1038/nrneurol.2013.271
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DOI: https://doi.org/10.1038/nrneurol.2013.271