JAMA Network JAMA Neurology : Intravenous Argatroban or Eptifibatide and Mechanical Thrombectomy
Aug 18, 2025
Colin P. Derdeyn, a leading interventional neuroradiologist from the University of Virginia, joins the conversation to discuss groundbreaking treatments for acute ischemic stroke. He delves into the challenges of conducting trials for drugs like intravenous Argatroban and Eptifibatide, exploring their efficacy in improving neurologic outcomes. The talk also highlights the potential of adjunct therapies to enhance thrombectomy procedures and the ongoing quest for better patient recovery methods following strokes.
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Career View: From tPA To Thrombectomy
- Colin P. Derdeyn described the evolution from IV tPA to thrombectomy across his career and the dramatic improvement in outcomes.
- He recalled
Why Recanalization Isn't Enough
- Despite effective thrombectomy, many patients remain moderately to severely disabled because reperfusion alone doesn't reverse all injury.
- Distal emboli and microcirculatory obstruction may explain poor recovery and are targets for adjunctive drugs.
Run Trials In High-Performing Networks
- Design acute stroke trials within StrokeNet or similar high-performing networks to enable rapid enrollment and intervention.
- Start study drugs as close to IV lytic administration as possible to better test adjunctive effects.