January 2024

The pharmacological intervention for ischemic stroke hinges on intravenous administration of the recombinant tissue-type plasminogen activator (rtPA, Alteplase/Actilyse®) either as a standalone treatment or in conjunction with thrombectomy. However, despite its clinical significance, broader employment of rtPA is constrained due to the risk of hemorrhagic transformations (HTs). Furthermore, the presence of diabetes or chronic hyperglycemia is associated with an elevated risk of HT subsequent to thrombolysis. This detrimental impact of tPA on the neurovascular unit in hyperglycemic patients has been