Antithrombotic and thrombolytic therapy for ischemic stroke.

Antithrombotic therapy is the mainstay of treatment for stroke prevention. Multiple antiplatelet agents are now proven options for patients at risk for stroke, whereas warfarin anticoagulation remains the preferred therapy for most patients with atrial fibrillation. Recent clinical trials have clarified the role of anticoagulation in acute stroke and in secondary prevention of noncardioembolic stroke. Intravenous tissue plasminogen activator is the only approved therapy for patients with acute ischemic stroke. Intra-arterial thrombolysis is emerging as a promising therapy in selected patients.