Roman Herzig, Tomáš Dorňák, David Školoudík, Daniel Šaňák
Intravenous thrombolysis (IVT) with administration of recombinant tissue plasminogen activator (rt-PA) represents basic standard treatment method of ischemic stroke within 4.5 h since symptoms onset. Nevertheless, the efficacy of IVT is relatively low in the occlusion of major cerebral artery. Bridging therapy (the combination of IVT and intra-arterial therapy [IAT]) enables the combination of the speed of intravenous rt-PA administration with higher recanalization rate achieved by IAT. Based on the results of so far published studies and meta-analysis, it seems that bridging therapy represents a therapeutic option in patients with documented occlusion of cerebral artery. Patients with isolated occlusion of the middle cerebral artery are probably the best candidates. It is necessary to shorten the time to treatment start in all patients and also IAT probably should be started as soon as possible and not considered only as a rescue strategy.