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https://www.readbyqxmd.com/read/28228620/a-case-of-intracranial-arterial-dolichoectasia-with-4-repeated-cerebral-infarctions-in-6-months-and-enlargement-of-basilar-artery
#1
Hideyuki Moriyoshi, Soma Furukawa, Mai Iwata, Junichiro Suzuki, Noriyoshi Nakai, Suguru Nishida, Yasuhiro Ito
A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy...
February 22, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28228323/evaluation-of-the-role-of-susceptibility-weighted-imaging-in-thrombolytic-therapy-for-acute-ischemic-stroke
#2
Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang
We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA)...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28222621/digestive-and-urologic-hemorrhage-after-intravenous-thrombolysis-for-acute-ischemic-stroke-data-from-a-chinese-stroke-center
#3
Hong Chang, Xiaojuan Wang, Xin Yang, Haiqing Song, Yuchen Qiao, Jia Liu
Objective Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) is considered the most effective treatment method for AIS; however, it is associated with a risk of hemorrhage. We analyzed the risk factors for digestive and urologic hemorrhage during rt-PA therapy. Methods We retrospectively analyzed patients with AIS who underwent intravenous thrombolysis with rt-PA during a 5-year period in a Chinese stroke center. Data on the demographics, medical history, laboratory test results, and clinical outcomes were collected...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28162169/-efficacy-of-intravenous-thrombolysis-in-acute-ischemic-stroke-with-hyperdense-middle-cerebral-artery-sign
#4
L Peng, Y Guo, Y Wang, Y N Lin, C H Zhang, H Y Wang, R M Yu, X P Sun
Objective: To observe the efficacy and safety of recombinant tissue-type plasminogen activator (rtPA) intravenous thrombolysis (IVT) in the treatment of acute cerebral infarction with hyperdense middle cerebral artery sign (HMCAS). Methods: Acute cerebral infarction patients with HMCAS from July 2010 to November 2015 at the First Affiliated Hospital of Dalian Medical University were collected.These patients were divided into two groups depending on whether they received IVT or not.The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28149081/not-only-the-sugar-early-infarct-sign-hyperdense-middle-cerebral-artery-age-neurologic-deficit-score-but-also-atrial-fibrillation-is-predictive-for-symptomatic-intracranial-hemorrhage-after-intravenous-recombinant-tissue-plasminogen-activator
#5
Sombat Muengtaweepongsa, Pornpoj Prapa-Anantachai, Pornpat A Dharmasaroja
BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is the most unwanted adverse event in patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (i.v. rt-PA). Many tool scores are available to predict the probability of sICH. Among those scores, the Sugar, Early infarct sign, hyperDense middle cerebral artery, Age, Neurologic deficit (SEDAN) gives the highest area under the curve-receiver operating characteristic value. OBJECTIVE: We aimed to examine any factors other than the SEDAN score to predict the probability of sICH...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28119380/use-of-intravenous-recombinant-tissue-plasminogen-activator-in-acute-ischemic-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-noacs-before-stroke
#6
Ying Xian, Jerome J Federspiel, Adrian F Hernandez, Daniel Laskowitz, Lee H Schwamm, Deepak L Bhatt, Eric E Smith, Gregg C Fonarow, Eric D Peterson
BACKGROUND: -Intravenous recombinant tissue plasminogen activator (rt-PA) is effective in improving outcomes in ischemic stroke; however, there are few data on use of rt-PA in patients who are receiving a non-vitamin K antagonist oral anticoagulant (NOAC). METHODS: -Using data from the American Heart Association Get With The Guidelines-Stroke Registry, we examined the outcomes of use of thrombolytic therapy in ischemic stroke patients receiving anticoagulation with NOACs versus those on warfarin (international normalized ratio <1...
January 24, 2017: Circulation
https://www.readbyqxmd.com/read/28110588/neuroprotective-effects-of-adjunctive-treatments-for-acute-stroke-thrombolysis-a-review-of-clinical-evidence
#7
Hongxing Zhou, Suyun Huang, Gavin Sunnassee, Weiyu Guo, Jian Chen, Yang Guo, Sheng Tan
The narrow therapeutic time window and risk of intracranial hemorrhage largely restrict the clinical application of thrombolysis in acute ischemic stroke. Adjunctive treatments added to rt-PA may be beneficial to improve the capacity of neural cell to withstand ischemia, and to reduce the hemorrhage risk as well. This review aims to evaluate the neuroprotective effects of adjunctive treatments in combination with thrombolytic therapy for acute ischemic stroke. Relevant studies were searched in the PubMed, Web of Science, and EMBASE database...
January 23, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28062805/intravenous-thrombolysis-before-endovascular-therapy-for-large-vessel-strokes-can-lead-to-significantly-higher-hospital-costs-without-improving-outcomes
#8
Ansaar T Rai, SoHyun Boo, Chelsea Buseman, Amelia K Adcock, Abdul R Tarabishy, Maurice M Miller, Thomas D Roberts, Jennifer R Domico, Jeffrey S Carpenter
BACKGROUND: Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. PURPOSE: To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). METHODS: A single-center retrospective analysis was performed...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27888608/efficacy-and-safety-of-combined-intraventricular-fibrinolysis-with-lumbar-drainage-for-prevention-of-permanent-shunt-dependency-after-intracerebral-hemorrhage-with-severe-ventricular-involvement-a-randomized-trial-and-individual-patient-data-meta-analysis
#9
Dimitre Staykov, Joji B Kuramatsu, Jürgen Bardutzky, Bastian Volbers, Stefan T Gerner, Stephan P Kloska, Arnd Doerfler, Stefan Schwab, Hagen B Huttner
OBJECTIVE: Intraventricular hemorrhage (IVH) is a negative prognostic factor in intracerebral hemorrhage (ICH) and is associated with permanent shunt dependency in a substantial proportion of patients post-ICH. IVH treatment by intraventricular fibrinolysis (IVF) was recently linked to reduced mortality rates in the CLEAR III study and IVF represents a safe and effective strategy to hasten clot resolution that may reduce shunt rates. Additionally, promising results from observational studies reported reductions in shunt dependency for a combined treatment approach of IVF plus lumbar drains (LDs)...
January 2017: Annals of Neurology
https://www.readbyqxmd.com/read/27857781/delayed-hemorrhage-after-surgery-and-radiation-in-suprasellar-pilocytic-astrocytomas
#10
REVIEW
Mazda K Turel, Tim-Rasmus Kiehl, Fred Gentili
Delayed intracranial hemorrhage is a rare complication of treatment for central nervous system tumors. This may be secondary to malignant transformation of the tumor or vasculopathy related to radiation therapy (RT). While most reports on radiation-induced vasculopathy in children with optic pathway gliomas are associated with ischemic complications, there are only two reports of hemorrhagic complications in these patients. In both cases, the hemorrhage was asymptomatic and remote from the site of the original tumor but within the field of irradiation...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27831633/therapeutic-effect-of-tenecteplase-on-treatment-of-cerebral-arterial-thrombosis-a-meta-analysis
#11
Y Zang, J Hou, L-Y Wang
OBJECTIVE: To evaluate the clinical efficacy between tenecteplase (TNK) and alteplase (rt-PA). Furthermore, suitable dosage of TNK in cerebral arterial thrombosis treatment was explored. MATERIALS AND METHODS: The studies met with the predefined selection criteria were selected for the present study. The quality of each study was evaluated by Cochrane quality evaluation. The outcome indexes including early major neurological improvement (MNI), excellent recovery, good recovery, recanalization at 24 hours-complete or partial, symptomatic intracranial hemorrhage, any parenchymal hematoma and deaths were analyzed by using RevMan and Stata statistical software, under a random-effects model or a fixed-effects model...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27815401/proportion-of-single-chain-recombinant-tissue-plasminogen-activator-and-outcome-after-stroke
#12
Didier Leys, Yannick Hommet, Clémence Jacquet, Solène Moulin, Igor Sibon, Jean-Louis Mas, Thierry Moulin, Maurice Giroud, Sharmila Sagnier, Charlotte Cordonnier, Elisabeth Medeiros de Bustos, Guillaume Turc, Thomas Ronzière, Yannick Bejot, Olivier Detante, Thavarak Ouk, Anne-Marie Mendyk, Pascal Favrole, Mathieu Zuber, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Francisco Macian Montoro, Chantal Lamy, Anthony Faivre, Laurent Lebouvier, Camille Potey, Mathilde Poli, Hilde Hénon, Pauline Renou, Nelly Dequatre-Ponchelle, Marie Bodenant, Sabrina Debruxelles, Costanza Rossi, Régis Bordet, Denis Vivien
OBJECTIVE: To determine whether the ratio single chain (sc)/(sc + 2 chain [tc]) recombinant tissue plasminogen activator (rtPA) influences outcomes in patients with cerebral ischemia. METHODS: We prospectively included consecutive patients treated with IV rtPA for cerebral ischemia in 13 stroke centers and determined the sc/(sc + tc) ratio in the treatment administered to each patient. We evaluated the outcome with the modified Rankin Scale (mRS) at 3 months (prespecified analysis) and occurrence of epileptic seizures (post hoc analysis)...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27781037/rescue-thrombectomy-in-large-vessel-occlusion-strokes-leads-to-better-outcomes-than-intravenous-thrombolysis-alone-a-real-world-applicability-of-the-recent-trials
#13
Raul G Nogueira, Osama O Zaidat, Alicia C Castonguay, Diogo C Haussen, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Albert J Yoo, Hashem Shaltoni, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Roberta Novakovic, Ashish Nanda, Ritesh Kaushal, Mohammad A Issa, Michael R Frankel, Rishi Gupta
BACKGROUND: The Interventional Management of Stroke III (IMS-III) trial demonstrated no benefit for intravenous recombinant tissue plasminogen activator (IV rt-PA) followed by endovascular therapy versus IV rt-PA alone. However, IMS-III mostly included earlier generation devices. The recent thrombectomy trials have incorporated the stent-retriever technology, but their generalizability remains unknown. METHODS: The North American Solitaire Acute Stroke (NASA) registry recruited patients treated with the Solitaire FR™ device between March 2012 and February 2013...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27773879/ultrasound-acceleration-of-rt-pa-thrombolysis-depends-on-acoustic-intensity
#14
Yoshikazu Sawaguchi, Zuojun Wang
Recombinant tissue-type plasminogen activator (rt-PA) is effective and widely used in the treatment of acute ischemic stroke (AIS). However, symptomatic intracranial hemorrhage (ICH), an adverse reaction of rt-PA, is known to occur depending on underlying diseases and rt-PA doses, and to occur more frequently with a greater delay from stroke onset until initiation of rt-PA. Therefore, limitations on the use of rt-PA, such as having to be started within 4.5 h of stroke onset, mean that rt-PA is only indicated in some stroke patients...
January 1, 2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/27699498/thrombolysis-in-dementia-patients-with-acute-stroke-is-it-justified
#15
REVIEW
Maurizio Paciaroni, Leonardo Pantoni
The administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient's population...
January 2017: Neurological Sciences
https://www.readbyqxmd.com/read/27644576/successful-emergency-carotid-endarterectomy-after-thrombolysis-with-intravenous-recombinant-tissue-type-plasminogen-activator
#16
Yoko Yamamoto, Toshiyuki Okazaki, Keishi Yoda, Yoshiteru Tada, Shinji Nagahiro
Acute internal carotid artery (ICA) occlusion may result in severe disability or death. Revascularization by carotid artery stenting after treatment with intravenous (iv) recombinant tissue-type plasminogen activator (rt-PA) has been documented. However, there are few reports on emergency carotid endarterectomy (CEA) within 24 hours after the iv administration of rt-PA. We treated a 58-year-old man with right ICA occlusion with iv rt-PA. Although partial recanalization of the ICA was obtained, severe stenosis at the origin of the ICA persisted and he developed fluctuating neurological deficits...
2016: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/27599906/accuracy-of-stroke-diagnosis-in-telestroke-guided-tissue-plasminogen-activator-patients
#17
Kunal Agrawal, Rema Raman, Karin Ernstrom, Robert Joseph Claycomb, Dawn Matherne Meyer, Thomas Martin Hemmen, Royya Fatima Modir, Pranav Kachhi, Brett Cowan Meyer
OBJECTIVES: The objective of the study is to assess the accuracy of final diagnosis in telestroke-guided tissue plasminogen activator (rt-PA) patients compared with bedside evaluation using computed tomography (CT) or magnetic resonance imaging (MRI) as a surrogate for final stroke diagnosis. The overall goal was to determine if telestroke had similar diagnostic accuracy as bedside evaluations in diagnosing rt-PA-treated patients. MATERIALS AND METHODS: We analyzed all acute stroke code calls who received intravenous rt-PA at our center from October 2013 to June 2015...
December 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27548625/update-on-the-effects-of-treatment-with-recombinant-tissue-type-plasminogen-activator-rt-pa-in-acute-ischemic-stroke
#18
Aldo Bonaventura, Fabrizio Montecucco, Franco Dallegri
INTRODUCTION: Acute ischemic stroke (AIS) represents a major cause of death and disability all over the world. The recommended therapy aims at dissolving the clot to re-establish quickly the blood flow to the brain and reduce neuronal injury. Intravenous administration of recombinant tissue-type plasminogen activator (rt-PA) is clinically used with this goal. AREAS COVERED: A description of beneficial and detrimental effects of rt-PA treatment is addressed. An overview of new therapies against AIS, such as new thrombolytics, sonolysis and sonothrombolysis, endovascular procedures, and association therapies is provided...
November 2016: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/27510959/a-retrospective-study-of-thrombolysis-with-0-6%C3%A2-mg-kg-recombinant-tissue-plasminogen-activator-rt-pa-in-mild-stroke
#19
Jie Yang, Fei Yu, Hong Liu, Hedi An, Ran Xiong, Dongya Huang
We sought to assess the safety, effectiveness and cost of 0.6 mg/kg rt-PA treatment for patients with acute mild stroke and to compare that with 0.9 mg/kg. We retrospectively analyzed consecutive acute ischemic stroke patients who had a NIHSS score ≤5 at admission and who were treated with rt-PA within 4.5 hours of symptom onset. The demographic data, clinical outcomes and hospitalization cost were analyzed. A total of 108 patients were included. Forty six patients (42.6%) received a 0.6 mg/kg dosage of rt-PA...
August 11, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27468616/-effect-of-intravenous-thrombolysis-with-recombinant-tissue-type-plasminogen-activator-rt-pa-in-different-time-windows-on-acute-cerebral-infarction-patients-with-atrial-fibrillation
#20
Y Guo, C H Zhang, H Y Wang, Y N Lin, Y Wang, X P Sun
OBJECTIVES: To observe the intravenous thrombolysis effect of rt-PA in different time windows of acute cerebral infarction with atrial fibrillation(AF). METHODS: Acute cerebral infarction patients who accepted the intravenous thrombolysis treatment with AF from January 2012 to December 2015 were included.According to the time from onset to intravenous thrombolysis, patients were divided into two groups: thrombolysis within 3 h and thrombolysis between 3-4.5 h. The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects...
July 12, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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