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https://www.readbyqxmd.com/read/29908146/intravenous-xenogeneic-human-cardiosphere-derived-cell-extracellular-vesicles-exosomes-improves-behavioral-function-in-small-clot-embolized-rabbits
#1
Paul A Lapchak, Paul D Boitano, Geoffrey de Couto, Eduardo Marbán
Acute ischemic stroke is devastating to patients and their families because of few viable therapeutic options to promote recovery after reperfusion windows close. Recent breakthroughs in biotechnology have resulted in a reproducible patented process for the purification of extracellular vesicles (EVs) from human cardiosphere-derived cells (CDCs). Because CDC-EVs have many features potentially beneficial to treat acute ischemic stroke, CDC-EVs were evaluated in an established small-clot rabbit embolic stroke model, where clinically relevant end points were used to assess recovery in a more translational large animal model...
June 13, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29869110/safety-of-urgent-sta-mca-anastomosis-after-intravenous-rt-pa-treatment-a-report-of-five-cases-and-literature-review
#2
Ryo Kanematsu, Toshikazu Kimura, Yasumitsu Ichikawa, Tomohiro Inoue
BACKGROUND: Intravenous recombinant tissue-type plasminogen activator (rt-PA) with/without endovascular treatment is not as effective in atherosclerotic steno-occlusive acute ischemic stroke. Urgent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is effective to some extent in progressing stroke, but the safety of STA-MCA anastomosis soon after rt-PA therapy is unknown. Our aim was to clarify the safety of STA-MCA anastomosis within 24 h after intravenous rt-PA...
June 4, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29778315/the-risk-of-hemorrhagic-transformation-after-thrombolysis-for-acute-ischemic-stroke-in-chinese-versus-north-americans-a-comparative-study
#3
Xiaomeng Xu, Deren Wang, Fang Wang, Casey Norton, Xinfeng Liu, Magdy Selim
BACKGROUND: There is a widespread belief that Asians are more susceptible to hemorrhagic transformation (HT) after receiving recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke (AIS). However, this has not been examined in clinical practice. This study aims to compare the incidence of symptomatic hemorrhagic transformation (SHT) among thrombolysis-treated AIS patients in China and in the United States. METHODS: We compared 212 consecutive patients receiving thrombolysis within 4...
May 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29761023/comparing-outcome-and-recanalization-results-in-patients-with-anterior-circulation-stroke-following-endovascular-treatment-with-and-without-a-treatment-with-rt-pa-a-single-center-study
#4
Mohamed Al-Khaled, Toralf Brüning, Carina Gottwald, Florian Roessler, Georg Royl, Thomas Eckey
Objectives: Endovascular treatment (ET), in addition to a therapy with intravenous recombinant tissue plasminogen activator IV rt-PA in patients with acute ischemic stroke, has been found to improve outcome. However, data about ET in patients who have not received therapy with rt-PA due to contraindications for IV rt-PA are sparse. Comparison of ET with IV rt-PA versus ET alone in patients with stroke is done using a proximal intracranial arterial occlusion (internal carotid artery, middle cerebral artery (M1-Segment))...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29740726/minimally-invasive-surgery-for-intracerebral-hemorrhage
#5
REVIEW
Eliza H Hersh, Yakov Gologorsky, Alex G Chartrain, J Mocco, Christopher P Kellner
PURPOSE OF REVIEW: Recent success in preliminary clinical studies evaluating various forms of minimally invasive surgery for spontaneous intracerebral hemorrhage (ICH) has renewed interest in the surgical treatment of this disease process. RECENT FINDINGS: In December of 2016, phase 2 of the Minimally Invasive Surgery Plus Rt-PA for ICH Evacuation (MISTIE) study demonstrated that this form of stereotactic thrombolysis safely reduces clot burden and may improve functional outcome 6 months after injury...
May 9, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29681849/danhong-injection-combined-with-t-pa-improves-thrombolytic-therapy-in-focal-embolic-stroke
#6
Min Li, Jing Zhou, Weifeng Jin, Xiaohong Li, Yuyan Zhang
Background: Hemorrhagic transformation, neurotoxicity, short treatment time windows, and other defects are considered as the major limitations for the thrombolytic therapy. This study is devoted to figure out whether Danhong injection (DHI) combined with tissue-plasminogen activator (t-PA) could extend the treatment time windows and ameliorate brain injury, hemorrhagic complication and BBB disruption after focal embolic stroke. Methods: In vitro , the combined concentrations of DHI and t-PA were added to wells reacted with plasminogen and D-Val-Leu-Lys-AMC...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29651748/improved-reperfusion-and-vasculoprotection-by-the-poly-adp-ribose-polymerase-inhibitor-pj34-after-stroke-and-thrombolysis-in-mice
#7
Mohamad El Amki, Dominique Lerouet, Marie Garraud, Fei Teng, Virginie Beray-Berthat, Bérard Coqueran, Benoît Barsacq, Charlotte Abbou, Bruno Palmier, Catherine Marchand-Leroux, Isabelle Margaill
Benefits from thrombolysis with recombinant tissue plasminogen activator (rt-PA) after ischemic stroke remain limited due to a narrow therapeutic window, low reperfusion rates, and increased risk of hemorrhagic transformations (HT). Experimental data showed that rt-PA enhances the post-ischemic activation of poly(ADP-ribose)polymerase (PARP) which in turn contributes to blood-brain barrier injury. The aim of the present study was to evaluate whether PJ34, a potent PARP inhibitor, improves poor reperfusion induced by delayed rt-PA administration, exerts vasculoprotective effects, and finally increases the therapeutic window of rt-PA...
April 12, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29555397/thrombolytic-therapy-in-severe-cardioembolic-stroke-after-reversal-of-dabigatran-with-idarucizumab-case-report-and-literature-review
#8
Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29549467/influence-of-on-going-treatment-with-angiotensin-converting-enzyme-inhibitor-or-angiotensin-receptor-blocker-on-the-outcome-of-patients-treated-with-intravenous-rt-pa-for-ischemic-stroke
#9
Sixtine Gilliot, Igor Sibon, Jean-Louis Mas, Thierry Moulin, Yannick Béjot, Charlotte Cordonnier, Maurice Giroud, Pascal Odou, Régis Bordet, Denis Vivien, Didier Leys
BACKGROUND: Many patients who receive intravenous (i.v.) recombinant tissue-plasminogen activator (rt-PA) for acute cerebral ischemia were under angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) at stroke onset. ACE-Is and ARBs have neuroprotective properties in animal models. OBJECTIVE: To evaluate whether the 3-month outcome of patients treated with i.v. rt-PA for cerebral ischemia was influenced by on-going therapy with ACE-Is or ARBs...
May 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29503629/a-score-for-risk-of-thrombolysis-associated-hemorrhage-including-pretreatment-with-statins
#10
Hebun Erdur, Alexandros Polymeris, Ulrike Grittner, Jan F Scheitz, Serdar Tütüncü, David J Seiffge, Heinrich J Audebert, Christian H Nolte, Stefan T Engelter, Andrea Rocco
Background: Symptomatic intracranial hemorrhage (sICH) after intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) for acute ischemic stroke is associated with a poor functional outcome. We aimed to develop a score assessing risk of sICH including novel putative predictors-namely, pretreatment with statins and severe renal impairment. Methods: We analyzed our local cohort (Berlin) of patients receiving rt-PA for acute ischemic stroke between 2006 and 2016...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29501045/effects-of-edaravone-the-free-radical-scavenger-on-outcomes-in-acute-cerebral-infarction-patients-treated-with-ultra-early-thrombolysis-of-recombinant-tissue-plasminogen-activator
#11
Xian-Ru Lee, Gui-Ling Xiang
OBJECTIVES: Edaravone, a free radical scavenger, alleviates blood-brain barrier disruption in conjunction with suppression of the inflammatory reaction in acute cerebral infarction. Thrombolysis with recombinant tissue plasminogen activator (rtPA) is an established therapy for acute cerebral infarction patients. The purpose of this study was to assess the effects of edaravone on outcomes in acute cerebral infarction patients treated with ultra-early thrombolysis of iv-rt-PA. PATIENTS AND METHODS: We conducted a retrospective cohort study using the database of Ningbo First Hospital...
April 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29406970/adjuvant-intra-arterial-rt-pa-injection-at-the-initially-deployed-solitaire-stent-enhances-the-efficacy-of-mechanical-thrombectomy-in-acute-ischemic-stroke
#12
Ting-Yu Yi, Wen-Huo Chen, Yan-Min Wu, Mei-Fang Zhang, Ding-Lai Lin, Xiao-Hui Lin
BACKGROUND: Both intra-arterial recombinant tissue plasminogen activator (rt-PA) and stent retrieval are effective for treating acute ischemic stroke. The goal of this study was to evaluate the effectiveness of stent retrieval combined with intra-arterial rt-PA administration via micro-catheter (called the complex technique) in acute ischemic stroke. MATERIAL AND METHODS: A retrospective analysis was performed of 93 consecutive patients treated between 2015 and 2017 for occlusions of the intracranial large artery using the complex technique (n=37) or stent retrieval alone (n=56) in our stroke center...
March 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29398533/cerebral-microbleeds-are-an-independent-predictor-of-hemorrhagic-transformation-following-intravenous-alteplase-administration-in-acute-ischemic-stroke
#13
Nandakumar Nagaraja, Nudrat Tasneem, Amir Shaban, Sudeepta Dandapat, Uzair Ahmed, Bruno Policeni, Heena Olalde, Hyungsub Shim, Edgar A Samaniego, Connie Pieper, Santiago Ortega-Gutierrez, Enrique C Leira, Harold P Adams
BACKGROUND AND PURPOSE: Intravenous alteplase (rt-PA) increases the risk of hemorrhagic transformation of acute ischemic stroke. The objective of our study was to evaluate clinical, laboratory, and imaging predictors on forecasting the risk of hemorrhagic transformation following treatment with rt-PA. We also evaluated the factors associated with cerebral microbleeds that increase the risk of hemorrhagic transformation. METHODS: Consecutive patients with acute ischemic stroke admitted between January 1, 2009 and December 31, 2013 were included in the study if they received IV rt-PA, had magnetic resonance imaging (MRI) of the brain on admission, and computed tomography or MRI of the brain at 24 (18-36) hours later to evaluate for the presence of hemorrhagic transformation...
May 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29336360/early-neurological-deterioration-after-recanalization-treatment-in-patients-with-acute-ischemic-stroke-a-retrospective-study
#14
Ying-Bo Zhang, Ying-Ying Su, Yan-Bo He, Yi-Fei Liu, Gang Liu, Lin-Lin Fan
BACKGROUND: Early neurological deterioration (END) is a prominent issue after recanalization treatment. However, few studies have reported the characteristics of END after endovascular treatment (EVT) as so far. This study investigated the incidence, composition, and outcomes of END after intravenous recombinant tissue plasminogen activator (IV rt-PA) and EVT of acute ischemic stroke, and identified risk factors for END. METHODS: Medical records of patients who received recanalization treatment between January 1, 2014, and December 31, 2015 were reviewed...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29246591/the-effect-of-metabolic-syndrome-and-obesity-on-outcomes-of-acute-ischemic-stroke-patients-treated-with-systemic-thrombolysis
#15
Demet Funda Bas, Atilla Ozcan Ozdemir
Metabolic syndrome (MetS) is associated with increased risk of ischemic stroke; while central obesity has controversial effects on ischemic stroke. We investigated effects of MetS and obesity on clinical courses and outcomes of patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA). 319 patients treated with intravenous thrombolysis were included to our study. Metabolic syndrome was determined if ≥3 of following criteria are present: elevated waist circumference; elevated triglycerides; reduced high density-lipoprotein cholesterol (HDL-C); elevated blood pressure; elevated fasting glucose...
December 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29232256/prognosis-comparisons-in-acute-ischemic-stroke-patients-with-thrombolysis-and-nonthrombolysis-therapy-a-retrospective-study-with-larger-sample-size
#16
Haojun Li, Yupeng Wu
: We compared the short-term, middle-term and long-term primary outcomes between thrombolysis and nonthrombolysis therapy in acute ischemic stroke (AIS) patients. Medical records were collected from patients suffered from AIS between 2010 and 2013 and allocated into either the intravenous recombinant tissue plasminogen activator (as rt-PA group) treatment, or non-rt-PA treatment group (as control group). The primary outcomes included a proportion of patients with favorable outcome [as defined with a modified Rankin Scale (mRS) of 0-1], functional independence (mRS of 0-2) or with bad outcome (mRS of 5-6) at 3, 6 and 12 months and the overall mortality...
March 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29221968/clinical-study-of-intravenous-low-dose-recombinant-tissue-plasminogen-activator-for-acute-cerebral-infarction-comparison-of-treatment-within-3-hours-versus-3-4-5-hours
#17
Ichiro Deguchi, Norio Tanahashi, Masaki Takao
BACKGROUND: An intravenous recombinant tissue plasminogen activator (rt-PA, alteplase .6 mg/kg) for acute cerebral infarction within 3 hours of onset was approved in Japan in 2005. The treatment window was subsequently extended to within 4.5 hours of onset. However, few Japanese studies have compared the efficacy and safety of rt-PA therapy between patients treated within 3 hours and patients treated within 3-4.5 hours. METHODS: This study included 323 patients who received rt-PA for acute cerebral infarction within 3 hours or 3-4...
April 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29217457/focusing-on-claudin-5-a-promising-candidate-in-the-regulation-of-bbb-to-treat-ischemic-stroke
#18
REVIEW
Jianjun Lv, Wei Hu, Zhi Yang, Tian Li, Shuai Jiang, Zhiqiang Ma, Fulin Chen, Yang Yang
Claudin-5 is a tight junction (TJ) protein in the blood-brain barrier (BBB) that has recently attracted increased attention. Numerous studies have demonstrated that claudin-5 regulates the integrity and permeability of the BBB. Increased claudin-5 expression plays a neuroprotective role in neurological diseases, particularly in cerebral ischemic stroke. Moreover, claudin-5 might be a potential marker for early hemorrhagic transformation detection in ischemic stroke. In light of the distinctive effects of claudin-5 on the nervous system, we present the elaborate network of roles that claudin-5 plays in ischemic stroke...
February 2018: Progress in Neurobiology
https://www.readbyqxmd.com/read/29216534/thrombolytic-therapy-based-on-fucoidan-functionalized-polymer-nanoparticles-targeting-p-selectin
#19
Maya Juenet, Rachida Aid-Launais, Bo Li, Alice Berger, Joël Aerts, Véronique Ollivier, Antonino Nicoletti, Didier Letourneur, Cédric Chauvierre
Injection of recombinant tissue plasminogen activator (rt-PA) is the standard drug treatment for thrombolysis. However, rt-PA shows risk of hemorrhages and limited efficiency even at high doses. Polysaccharide-poly(isobutylcyanoacrylate) nanoparticles functionalized with fucoidan and loaded with rt-PA were designed to accumulate on the thrombus. Fucoidan has a nanomolar affinity for the P-selectin expressed by activated platelets in the thrombus. Solid spherical fluorescent nanoparticles with a hydrodynamic diameter of 136 ± 4 nm were synthesized by redox radical emulsion polymerization...
February 2018: Biomaterials
https://www.readbyqxmd.com/read/29191741/thrombolytic-therapy-of-acute-ischemic-stroke-during-early-pregnancy
#20
Anne Landais, Hugo Chaumont, Rachel Dellis
Thrombolytic treatment (recombinant tissue plasminogen activator [rt-PA]) has established efficacy in acute ischemic stroke, but pregnancy has been an exclusion criterion for all clinical trials that validated alteplase in acute stroke, so our knowledge about its use in this condition is limited. Herein we report the successful use of intravenous rt-PA thrombolysis, uncomplicated by neither hemorrhage development nor other complication in a woman who was 13 weeks pregnant with acute ischemic stroke. The brain magnetic resonance imaging diffusion-weighted sequences showed increased signal in the territory of the left middle cerebral artery...
February 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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