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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
#1
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 after 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 (LD)...
November 26, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27857781/delayed-hemorrhage-after-surgery-and-radiation-in-suprasellar-pilocytic-astrocytomas
#2
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
#3
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
#4
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
#5
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
#6
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 hours of stroke onset, mean that rt-PA is only indicated in some stroke patients...
October 22, 2016: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/27699498/thrombolysis-in-dementia-patients-with-acute-stroke-is-it-justified
#7
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...
October 3, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27644576/successful-emergency-carotid-endarterectomy-after-thrombolysis-with-intravenous-recombinant-tissue-type-plasminogen-activator
#8
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
#9
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...
September 2, 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
#10
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
#11
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
#12
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]
https://www.readbyqxmd.com/read/27443695/timing-of-symptomatic-infarct-swelling-following-intravenous-thrombolysis-in-acute-middle-cerebral-artery-infarction-a-case-control-study
#13
Ting-Chun Lin, Jiann-Der Lee, Ya-Hui Lin, Rey-Yue Yuan, Hsu-Huei Weng, Ying-Chih Huang, Meng Lee, Chih-Ying Wu, Huan-Lin Hsu, Chia-Yu Hsu, Tsong-Hai Lee, Shan-Jin Liu, Yeu-Jhy Chang, Chien-Hung Chang, Tsung-I Peng, Chia-Wei Liou, Ku-Chou Chang, Yi-Ting Pan, Yen-Chu Huang
BACKGROUND: The risk of symptomatic infarct swelling has been reported to be higher in patients treated with recombinant tissue plasminogen activator (rt-PA). The aim of this study was to evaluate the timing of symptomatic infarct swelling after rt-PA treatment. METHODS: We retrospectively analyzed 14 868 patients with acute ischemic stroke from a stroke registry databank. We recruited patients with massive middle cerebral artery (MCA) infarction and symptomatic infarct swelling and excluded those with parenchymal or symptomatic hemorrhage...
July 21, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27401375/-intravenous-thrombolysis-for-ischemic-stroke-experience-in-54-patients
#14
Carlos Guevara O, Kateryna Bulatova, Felipe Aravena, Sheila Caba, Juan Monsalve, Hugo Lara, Elena Nieto, Isabel Navarrete, Marcelo Morales
BACKGROUND: Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties. AIM: To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital. MATERIAL AND METHODS: During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated...
April 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27352315/efficacy-and-safety-evaluation-on-arterial-thrombolysis-in-treating-acute-cerebral-infarction
#15
Baozhong Shen, Qingan Liu, Yingli Gu, Yan Wang, Zhuobo Zhang
The objective of this study was to evaluate the efficacy and safety of intra-arterial thrombolysis in treating acute cerebral infarction and further discuss the indications of acute cerebral infarction treatment, in order to enhance the therapeutic effects of arterial thrombolysis. The data of 164 patients with acute cerebral infarction who accepted intra-arterial thrombolysis treatment by using rt-PA or reteplase between 2009 and 2014 at the Department of Neurology of our hospital, were collected, including patients' medical history, characteristics of the onset procedure, intervals between onset and intra-arterial thrombolysis, bleeding or death, and the changing process of patient's main neurologic function after the treatment...
November 2015: Cell Biochemistry and Biophysics
https://www.readbyqxmd.com/read/27333939/drip-and-ship-thrombolytic-therapy-supported-by-the-telestroke-system-for-acute-ischemic-stroke-patients-living-in-medically-under-served-areas
#16
Teruyoshi Kageji, Fumiaki Obata, Hirofumi Oka, Yasuhisa Kanematsu, Ryo Tabata, Kenji Tani, Hiroyasu Bando, Shinji Nagahiro
There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Prefectural Kaifu Hospital (TPKH), located in rural Japan, can relay CT or MRI scans and other patient data via their smart phone to off-site stroke specialists...
June 22, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/27333751/-anticoagulation-for-patients-with-non-valvular-atrial-fibrillation
#17
REVIEW
Tadataka Mizoguchi, Masahiro Yasaka
Non-valvular atrial fibrillation (NVAF) is the most common cardiac source of emboli in cardioembolic stroke which occupies from 1/4 to 1/3 of acute brain infarction in Japan. Non-vitamin K antagonist oral anticoagulants (NOAC) have been used widely because they are easy to use, their effect in preventing ischemic stroke is higher than or as high as warfarin, their incidence of major hemorrhage is lower than or as low as warfarin, and their incidence of intracranial hemorrhage is much lower than warfarin. However, there seem several issues to address regarding NOAC treatment, such as reversal of anticoagulation, antidotes, monitoring of anticoagulation, rt-PA treatment for acute stroke patients treated with NOACs...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27152469/validation-of-turn-a-simple-predictor-of-symptomatic-intracerebral-hemorrhage-after-iv-thrombolysis
#18
David Asuzu, Karin Nystrӧm, Hardik Amin, Joseph Schindler, Charles Wira, David Greer, Nai Fang Chi, Janet Halliday, Kevin N Sheth
OBJECTIVE: We recently described TURN (Thrombolysis risk Using mRS and NIHSS), a computationally simple tool for predicting symptomatic intracerebral hemorrhage (sICH) after IV thrombolysis (rt-PA). Our objective was to compare TURN to existing scores for predicting sICH. METHODS: Our internal dataset consisted of 210 ischemic stroke patients receiving IV rt-PA from January 2009 until July 2013 at Yale New Haven Hospital. Our external dataset included 303 patients who received IV rt-PA during the NINDS rt-PA trial...
July 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27088493/high-plasma-d-dimer-indicates-unfavorable-outcome-of-acute-ischemic-stroke-patients-receiving-intravenous-thrombolysis
#19
Po-Jen Hsu, Chih-Hao Chen, Shin-Joe Yeh, Li-Kai Tsai, Sung-Chun Tang, Jiann-Shing Jeng
BACKGROUND: D-dimer is a fibrin degradation product and a possible marker of thromboembolic events. The aim of this study was to investigate the relationship between D-dimer levels and outcome in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis. METHODS: This retrospective study included AIS patients who received intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) and provided plasma D-dimer level within 24 h after stroke onset during 2009 and 2014 at a single medical center...
2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/26949121/intravitreal-tissue-plasminogen-activator-ranibizumab-and-gas-injection-for-submacular-hemorrhage-in-polypoidal-choroidal-vasculopathy
#20
Yorihisa Kitagawa, Hiroyuki Shimada, Ryusaburo Mori, Kouji Tanaka, Mitsuko Yuzawa
PURPOSE: To investigate the efficacy of intravitreal injection of recombinant tissue plasminogen activator (rt-PA), ranibizumab, and gas without vitrectomy for submacular hemorrhage. DESIGN: Prospective, interventional, consecutive case series. PARTICIPANTS: Twenty consecutive patients (20 eyes) with submacular hemorrhage secondary to exudative age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV). METHODS: Ranibizumab, rt-PA (25 μg/0...
June 2016: Ophthalmology
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