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Review

Intravenous Thrombolysis with Urokinase for Acute Ischemic Stroke

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
(This article belongs to the Section Neuropharmacology and Neuropathology)

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.
Keywords: intravenous thrombolysis; urokinase; acute ischemic stroke; cerebrovascular disease intravenous thrombolysis; urokinase; acute ischemic stroke; cerebrovascular disease

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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