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Editorial
December 9, 2019

Potential of Intra-arterial Urokinase After Incomplete Mechanical Thrombectomy—Looking Back, Moving Forward

Author Affiliations
  • 1Department of Neurology, UTHealth McGovern Medical School, Houston, Texas
JAMA Neurol. 2020;77(3):298-299. doi:10.1001/jamaneurol.2019.3984

Complete and rapid revascularization can dramatically reduce disability after large-vessel occlusion (LVO) acute ischemic stroke (AIS).1 With modern mechanical thrombectomy (MT), we now have a safe and effective method to recanalize occluded cerebral vessels, and in this issue of JAMA Neurology, Kaesmacher et al2 move the field 1 step closer to achieving the goal of complete revascularization. Cohort studies have demonstrated that even among patients who achieve substantial reperfusion, defined as a Thrombolysis in Cerebral Infarction grade of 2b or greater, those who achieve the highest grades of reperfusion have quantifiably improved outcomes, but only a minority are able to achieve these highest grades.3 As such, one of the primary targets for improvement in MT is finding reliable means of achieving near-perfect reperfusion.

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