This retrospective article examines the evolution of treatments for Acute Ischemic Stroke (AIS) over three decades. From initial attempts in the 1970s to the introduction of recombinant Tissue Plasminogen Activator (r-tPA) in 1995, significant progress is highlighted. Mechanical thrombectomy, using devices such as Merci Retriever and Solitaire®, provides alternatives for patients unsuitable for chemical thrombolysis. The comparison between thrombolysis and thrombectomy, along with their combined use, underscores the need for individualized assessments.
Despite challenges, advances in imaging technology extend therapeutic windows. The introduction of advanced equipment and artificial intelligence-assisted analysis tools enhances precise detection of penumbra areas. While challenges persist, such as a lack of awareness among some physicians, research and clinical application offer an optimistic outlook. Personalization of therapies, expansion of therapeutic windows, and integration of technology promise to improve outcomes and quality of life. In this landscape, a promising future is envisioned where innovation and personalization will transform AIS care
