Treatment of Ischemic Stroke General stroke treatments Acute antihypertensive therapy only in certain circumstances Antiplatelet therapy For acute treatment, sometimes reperfusion with recombinant tissue plasminogen activator (IV or thrombolysis-in-situ), and / or mechanical thrombectomy Sometimes anticoagulation Long-term control of risk factors Sometimes carotid endarterectomy or stenting Acute stroke treatment Guidelines for early management of stroke are available from the American Heart Association and American Stroke Association.