An overview of adjunctive therapies and alternatives to reperfusion management to reduce cerebral infarct size.

Abstract

Stroke remains a leading cause of morbidity and mortality, imposing a substantial financial burden on healthcare systems and significantly impacting survivors' quality of life. Endovascular recanalization through thrombolysis and/or thrombectomy is the current standard of care for ischemic stroke. However, these interventions are constrained by a narrow therapeutic window, and stroke outcomes remain suboptimal despite timely treatment. Clinical evidence suggests a strong correlation between infarct size and adverse clinical outcomes. This review explores existing literature and emerging therapeutic strategies beyond endovascular recanalization that aim to reduce cerebral infarct size. It identifies a variety of interventions that have shown therapeutic potential, particularly in animal models. However, it highlights that findings from animal studies have yet to be extensively translated into humans and may be an asset to improving neurological recovery and overall patient outcomes. Additionally, this review emphasizes the need for adjunctive therapies to complement standard reperfusion treatment, with the goal of improving neurological recovery and overall patient outcomes.