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AHA/ASA ischemic stroke

Gang Wang, Bangjiang Fang, Xuezhong Yu, Zhijun Li
In 2018, the American Heart Association/American Stroke Association (AHA/ASA) has developed the latest 2018 guidelines for the early management of patients with acute ischemic stroke (AIS), based on the latest evidences. The 2018 guidelines including recommendations on pre-hospital and in-hospital management treatment, has revised and add new recommendations from 2013 guideline. The major changes in 2018 guideline involve applications of brain imaging in early stage, intravenous thrombolysis and mechanical thrombectomy, et al...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
C Kuate-Tegueu, J J Dongmo-Tajeuna, J Doumbe, Y Mapoure-Njankouo, G Noubissi, V D P Djientcheu
BACKGROUND: High blood pressure (HBP) is common at acute phase of stroke. It may reflect untreated or uncontrolled hypertension before stroke, or it may relate to stress response. The present study was designed to compare current American Stroke Association (ASA) guidelines with actual prescribing patterns for management of HBP at the acute phase of stroke, in a tertiary care Hospital in Douala, Cameroon. METHODS: This cross-sectional study was conducted in the Cardiology and Neurology department of the Douala Laquintinie Hospital...
November 15, 2017: Journal of the Neurological Sciences
Larissa Georgeon, Philip B Gorelick, Tenko Raykov, Muhammad U Farooq, Jiangyong Min, Christopher Goshgarian, Bradley Haveman-Gould, Amy Groenhout, Molly McCarthy
We carried out a quality improvement project utilizing the electronic medical record (EMR) to determine (1) the quality of vascular neurologists' recommendations for recurrent stroke prevention and (2) primary care provider (PCP) acknowledgement of the vascular neurologists' recurrent stroke prevention recommendations and their frequency of meeting the recommended metrics for risk factor control and lifestyle modification. We conducted a retrospective EMR chart review on a convenience sample of ischemic stroke patients during two epochs...
December 2017: Neurological Sciences
Osama O Zaidat, Alicia C Castonguay, Raul G Nogueira, Diogo C Haussen, Joey D English, Sudhakar R Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J Binning, Ajit Puri, Nirav A Vora, Ron F Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Maxim Mokin, Aniel Q Majjhoo, Mouhammed R Kabbani, Michael T Froehler, Ira Finch, Sameer A Ansari, Roberta Novakovic, Thanh N Nguyen
BACKGROUND: Recent randomized clinical trials (RCTs) demonstrated the efficacy of mechanical thrombectomy using stent-retrievers in patients with acute ischemic stroke (AIS) with large vessel occlusions; however, it remains unclear if these results translate to a real-world setting. The TREVO Stent-Retriever Acute Stroke (TRACK) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice. METHODS: Twenty-three centers enrolled consecutive AIS patients treated from March 2013 through August 2015 with the Trevo device...
September 29, 2017: Journal of Neurointerventional Surgery
Yu-Hsiang Su, Chih-Hung Chen, Huey-Juan Lin, Yu-Wei Chen, Mei-Chiun Tseng, Han-Chieh Hsieh, Chih-Hung Chen, Sheng-Feng Sung
PURPOSE: Only a small percentage of ischemic stroke patients were treated with intravenous thrombolysis in Taiwan, partly because of the narrow reimbursement criteria of the National Health Insurance (NHI). We aimed to assess the safety and effectiveness of intravenous thrombolysis not covered by the NHI. METHODS: This is a retrospective analysis of register data from four hospitals. All patients who received intravenous tissue plasminogen activator and fulfilled the American Heart Association/American Stroke Association (AHA/ASA) thrombolysis guidelines between January 2007 and June 2012 were distinguished into two groups: those in accordance (reimbursement group) and those not in accordance (non-reimbursement group) with the NHI reimbursement criteria...
March 15, 2017: Acta Neurologica Taiwanica
Sami Al Kasab, Michael J Lynn, Tanya N Turan, Colin P Derdeyn, David Fiorella, Bethany F Lane, L Scott Janis, Marc I Chimowitz
BACKGROUND: An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting <24 hours should be considered a stroke. We analyzed the impact of considering CITS as equivalent to stroke on the results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Digvijaya D Navalkele, Kristian Barlinn, Alireza Minagar, Oleg Y Chernyshev
BACKGROUND: Frequency of sleep-disordered breathing (SDB) among stroke and transient ischemic attack (TIA) patients ranges from 30-80% and is associated with poor neurological outcomes. Per current stroke prevention guidelines from American Heart Association/American Stroke Association (AHA/ASA), SDB is included in the list of modifiable risk factors for stroke and TIA prevention. Goal of our study is to determine screening practices for SDB in stroke medical community. METHODS: A web-based survey was sent to physicians taking care of stroke patients across North America and Europe...
June 2016: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Badih Daou, Maureen Deprince, Robin D'Ambrosio, Stavropoula Tjoumakaris, Robert H Rosenwasser, Daniel J Ackerman, Rodney Bell, Diana L Tzeng, Michelle Ghobrial, Andres Fernandez, Qaisar Shah, Dan J Gzesh, Deborah Murphy, John E Castaldo, Claranne Mathiesen, Maria Carissa Pineda, Pascal Jabbour
OBJECTIVE: Recently, the FDA guidelines regarding the eligibility of patients with acute ischemic stroke to receive IV rt-PA have been modified and are not in complete accord with the latest AHA/ASA guidelines. The resultant differences may result in discrepancies in patient selection for intravenous thrombolysis. METHODS: Several comprehensive stroke centers in the state of Pennsylvania have undertaken a collaborative effort to clarify and unify our own recommendations regarding how to reconcile these different guidelines...
December 2015: Clinical Neurology and Neurosurgery
Mitch Hargis, Jharna N Shah, Janine Mazabob, Chethan Venkatasubba Rao, Jose I Suarez, Eric M Bershad
OBJECTIVE: The logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting. METHODS: A 21 question survey was distributed to attendees of the AHA/ASA Southwest Affiliate Stroke Coordinators Conference to evaluate potential barriers and delays with regards to thrombolysis for acute strokes patients in the Emergency Department setting...
August 2015: Clinical Neurology and Neurosurgery
Stephen J Marks, Sahil Khera
Cryptogenic stroke (CS) accounts for 20% to 40% of ischemic strokes. CS is defined as a cortical infarct suggestive of an embolic stroke with no identifiable cardiac etiology, large vessel occlusive disease, or small vessel lacunar stroke. The likely etiologies for CS are patent foramen ovale (PFO) and paroxysmal atrial fibrillation, which can be detected by transesophageal echocardiography and long-term cardiac rhythm monitoring. In a busy academic hospital, the stroke service is frequently asked to provide a rational approach to patients with such a presentation...
July 2016: Cardiology in Review
Eric E Smith, Jeffrey L Saver, David N Alexander, Karen L Furie, L Nelson Hopkins, Irene L Katzan, Jason S Mackey, Elaine L Miller, Lee H Schwamm, Linda S Williams
No abstract text is available yet for this article.
November 2014: Stroke; a Journal of Cerebral Circulation
Hamidreza Kafi, Jamshid Salamzadeh, Nahid Beladimoghadam, Mohammad Sistanizad, Mehran Kouchek
Ischemic stroke is amongst the top four causes of mortality and the leading cause of disability in the world. The aim of this study was to evaluate the efficacy of a high dose memantine on neurological function of patients with ischemic stroke. In a randomized, 2 armed, open-label study, patients with mild to moderate cerebral thromboembolic event (CTEE) who admitted to Imam Hossein Hospital, Tehran, Iran, during preceding 24 hours, entered the study. Patients allocated in two study groups of memantine (as add-on therapy) and control...
2014: Iranian Journal of Pharmaceutical Research: IJPR
Sydney A Jones, Rebecca F Gottesman, Eyal Shahar, Lisa Wruck, Wayne D Rosamond
BACKGROUND AND PURPOSE: Characterizing International Classification of Disease 9th Revision, Clinical Modification (ICD-9-CM) code validity is essential given widespread use of hospital discharge databases in research. Using the Atherosclerosis Risk in Communities (ARIC) Study, we estimated the accuracy of ICD-9-CM stroke codes. METHODS: Hospitalizations with ICD-9-CM codes 430 to 438 or stroke keywords in the discharge summary were abstracted for ARIC cohort members (1987-2010)...
November 2014: Stroke; a Journal of Cerebral Circulation
Ganesh Asaithambi, Xin Tong, Mary G George, Albert W Tsai, James M Peacock, Russell V Luepker, Kamakshi Lakshminarayan
BACKGROUND: The American Heart Association/American Stroke Association (AHA/ASA) recommended an expansion of the time window for acute ischemic stroke (AIS) reperfusion with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) from 3 to 4.5 hours after symptom onset. We examine rates of IV and intra-arterial (IA) reperfusion before and after the recommendations to track guideline adoption in community practice. METHODS: Patients with AIS in the Paul Coverdell National Acute Stroke Registry spanning years 2007-2012 were identified...
October 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Harsh R Aggarwal, Ameer E Hassan, Gustavo J Rodriguez, M Fareed K Suri, Robert A Taylor, Adnan I Qureshi
OBJECTIVE: To determine the rates of symptomatic intracerebral hemorrhages (sICH), parenchymal hematoma type 2 (PH2), and favorable outcomes in patients with borderline elevation of international normalized ratio (INR) or recent anticoagulation use prior to treatment with intravenous recombinant tissue plasminogen activator (IV rt-PA) for acute ischemic stroke. METHODS: Consecutive patients with acute ischemic stroke that received IV rt-PA were identified. History of recent use of anticoagulation and the INR at presentation and after use of thrombolytics, up to 72 h was recorded...
December 2013: Journal of Vascular and Interventional Neurology
Flavio Augusto de Carvalho, Lee H Schwamm, Gustavo W Kuster, Monique Bueno Alves, Miguel Cendoroglo Neto, Gisele Sampaio Silva
BACKGROUND: Stroke is the fourth leading killer in the US, the first in Brazil and a leading cause of adult long-term disability in both countries. In spite of widespread recommendation, clinical practice guidelines have had limited effect on changing physician behavior. Recognizing that both knowledge and acceptance of guidelines do not necessarily imply guideline adherence, the American Heart Association/American Stroke Association (AHA/ASA) developed a national stroke quality improvement program, the 'Get With The Guidelines (GWTG) stroke'...
January 2012: Cerebrovascular Diseases Extra
Kathleen A Baldwin, Stacey L McCoy
Stroke is the third leading cause of death in the United States and the number one cause of adult long-term disability. Disability in stroke survivors includes hemiparesis, aphasia, inability to walk without assistance, dependence on others for activities of daily living, depression, and institutionalization. Immediate recognition of acute ischemic stroke (AIS) signs and symptoms is required because many treatment options are time sensitive. Hospital transport via activation of 911 and emergency medical services (EMSs) removes delays to urgent diagnosis and intervention...
October 2010: Journal of Pharmacy Practice
Molly A Hatcher, Jessica A Starr
OBJECTIVE: To evaluate the literature regarding the use of intravenous tissue plasminogen activator (tPA) in the treatment of acute ischemic stroke, focusing on the appropriate usage criteria and administration time window. DATA SOURCES: A PubMed and MEDLINE search was performed (1990-November 2010) using the key words alteplase, tissue plasminogen activator, thrombolytic, ischemic stroke, and cerebrovascular accident. STUDY SELECTION AND DATA EXTRACTION: Clinical trials published in English were evaluated and relevant primary literature evaluating the use of tPA in acute ischemic stroke was included...
March 2011: Annals of Pharmacotherapy
Joana Patrícia dos Santos Carvalho, Dora Lopes Castelo Branco Catre, Cláudia Margarida Brito Pereira, Marina Costa
BACKGROUND AND OBJECTIVES: Neoplasias can be associated with autoimmune hemolytic anemia (AHA) with the consequent blood incompatibility that hinders blood transfusion. The authors describe and discuss the conduct in three patients undergoing surgical intervention for neoplastic disease with positive Coombs Test (CT), and the impossibility to determine the blood type. CASE REPORT: 1st case: 87-year old male patient, ASA III, scheduled for surgery for colon neoplasia...
January 2010: Revista Brasileira de Anestesiologia
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