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Open AccessReview
Intravenous Thrombolysis with Urokinase for Acute Ischemic Stroke
by
Yue Qiao
Yue Qiao 1,†,
Jing Wang
Jing Wang 1,†,
Thanh Nguyen
Thanh Nguyen 2,
Lan Liu
Lan Liu 3,
Xunming Ji
Xunming Ji 3,4,* and
Wenbo Zhao
Wenbo Zhao 1,3,*
1
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
2
Department of Neurology and Radiology, Boston Medical Center, Boston, MA 02118, USA
3
Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
4
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Brain Sci. 2024, 14(10), 989; https://doi.org/10.3390/brainsci14100989 (registering DOI)
Submission received: 29 August 2024
/
Revised: 20 September 2024
/
Accepted: 26 September 2024
/
Published: 28 September 2024
Abstract
Background: Intravenous thrombolysis is one of the most effective therapies for the treatment of acute ischemic stroke (AIS), with urokinase offering a cost-effective alternative to newer agents like alteplase and tenecteplase, especially in resource-limited settings. Methods: This review provides a comprehensive overview of the application of intravenous thrombolysis with urokinase for AIS in the clinical practice of stroke management, including the efficacy, safety, and cost-effectiveness of urokinase compared to other thrombolytic agents. Results: Urokinase, a first-generation thrombolytic drug, is a non-specific plasminogen activator that offers a cost-effective alternative. It has been used in clinical practice for over two decades to improve neurological outcomes in patients with AIS if administered within 6 h of ictus. Numerous studies have indicated that urokinase remains a viable option for patients who cannot access alteplase or tenecteplase because of economic constraints, time window limitations, availability, or other reasons. Conclusions: In low- and middle-income countries, urokinase is a cost-effective alternative thrombolytic drug. High-level evidence-based medical research is therefore urgently needed to confirm that urokinase is not inferior to new-generation thrombolytic drugs, and to assess whether it may even be superior in some patient populations.
Share and Cite
MDPI and ACS Style
Qiao, Y.; Wang, J.; Nguyen, T.; Liu, L.; Ji, X.; Zhao, W.
Intravenous Thrombolysis with Urokinase for Acute Ischemic Stroke. Brain Sci. 2024, 14, 989.
https://doi.org/10.3390/brainsci14100989
AMA Style
Qiao Y, Wang J, Nguyen T, Liu L, Ji X, Zhao W.
Intravenous Thrombolysis with Urokinase for Acute Ischemic Stroke. Brain Sciences. 2024; 14(10):989.
https://doi.org/10.3390/brainsci14100989
Chicago/Turabian Style
Qiao, Yue, Jing Wang, Thanh Nguyen, Lan Liu, Xunming Ji, and Wenbo Zhao.
2024. "Intravenous Thrombolysis with Urokinase for Acute Ischemic Stroke" Brain Sciences 14, no. 10: 989.
https://doi.org/10.3390/brainsci14100989
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