The Need

By 2030, it is expected that the economic burden of AIS will exceed $180B in the US alone. AIS events can be classified into three categories. The first group consists of “mild” strokes (~35% of AIS events). Because neurological deficits and mortality rates are small, thrombolysis is usually contradicted due to the hemorrhage risk. Although “mild”, ~60% of mild stroke victims have poor outcomes with ~35% not functionally independent after 90 days. The second group consists of “wake-up” strokes (~25% of AIS events) which often occur during sleep. Nearly 60% of wake-up stroke patients are not functionally independent after 90 days. Because the time of the stroke is often not known, thrombolysis is generally withheld due to bleeding concerns. Although up to ~35% of the remaining AIS events could be eligible for thrombolysis, thrombolysis is used in only about 10% of cases due to physician concerns that a modest patient improvement is not worth the increased risk of intracranial hemorrhage or death. However, if thrombolysis could be made more effective without risking intracranial hemorrhage, nearly 10X more AIS patients could be treated.