There have been newer developments in the intervention phase of the stroke patient. As mentioned by Rubin et al. (2014), a transformation occurred with the use of common contrast with CT angiography. This newer technique allows for the visualization of larger arteries' occlusion and the area of irreversible injury to be seen as well (Rubin et al., 2014).
The next improvement for treatment has been the increase in time allowance for the use of thrombolytics. Although mentioned earlier in the text, this is worth mentioning as different approaches are being considered for the use of thrombolytics. The first mention of a 4.5-9-hour window has been mentioned by Oliveiro-Filho and Samuels (2021). But according to Rehani et al. (2019), this window may be extended up to 24 hours. The increased time window depends on the amount of collateral circulation observed by advanced imaging studies. Although still in its early stages, the clinical trial shows promise in helping to prevent increased debility from a stroke.
The use of neuroprotectants is also being studied to help reduce the severity and improve survival. In a preliminary animal study by Zhang et al. (2021), when the neuroprotectant named NA-1 was delivered to mice by nanoparticle delivery, it reduced both the severity and mortality of a stroke. This was an improvement because when the substance was introduced without the use of a nanoparticle, the results were not as good (Zhang et al., 2021). It appears that this nanoparticle acts as an antioxidant, delivering the peptide exactly where it needs to go in acting to reduce the size of the stroke, reduce cerebral edema, and improve mortality (Zhang et al., 2021). Although in its infancy, this type of intervention could potentially make a huge difference in acute stroke intervention.
One of the biggest advancements being used currently is mechanical thrombectomy on patients with large vessel acute ischemic stroke, which according to Guo and Miao (2021) accounts for 20% of acute ischemic strokes. The procedure, usually done in an interventional lab, can be carried out with moderate sedation and can be performed up to 24 hours from the time of symptom onset (Guo & Miao, 2021). The problem with the procedure, aside from the risks and benefits inherent in any procedure, lies in the availability of providers to perform it, per Tawil and Muir (2017). But, as mentioned by Neale (2020), it is not only the right thing to do in ensuring that all prospective patients in the United States have access to the procedure, but it is also proving to be more cost-effective with better outcomes for the patient and overall reduced cost of care over the life of the patient.