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Fibrinolysis stroke

Magdalena L Bochenek, Eva Schütz, Katrin Schäfer
Age is an important cardiovascular risk factor. Among others, age is associated with an increased risk to develop thrombotic cardiovascular complications, both in the arterial (acute myocardial infarction, stroke) and the venous (deep vein thrombosis, pulmonary embolism) system, which cannot be explained by the age-associated increase in cardiovascular risk factors alone. A number of studies have demonstrated that the accumulation of senescent endothelial cells and specific phenotypic and functional alterations associated with endothelial cell senescence may play an important role during the development and progression of cardiovascular disease...
September 20, 2016: Thrombosis Research
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
September 24, 2016: Advances in Experimental Medicine and Biology
Doo Sun Sim, Myung Ho Jeong, Youngkeun Ahn, Young Jo Kim, Shung Chull Chae, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Chong Jin Kim, Myeong Chan Cho, Seung-Woon Rha, Jang Ho Bae, Ki Bae Seung, Seung Jung Park
BACKGROUND: The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute ST-elevation or Non-ST-elevation Myocardial Infarction 2015 suggested that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PPCI). We sought to assess the clinical impact of pharmacoinvasive strategy compared with PPCI in real-world patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We used the Korea Acute Myocardial Infarction Registry to identify ST-segment-elevation myocardial infarction patients receiving either pharmacoinvasive strategy defined as fibrinolysis followed by percutaneous coronary intervention (rescue/urgent or routine elective; n=708) or PPCI (n=8878)...
September 2016: Circulation. Cardiovascular Interventions
Ozan Kocak, Coskun Yarar, Ayşe Bozkurt Turhan, Olga Meltem Akay, Kursat Bora Carman, Ayten Yakut
BACKGROUND: Perinatal arterial ischemic stroke (PAIS) is an important cause of pediatric morbidity and mortality. The etiology of PAIS remains unknown. Several maternal-neonatal disorders, and especially prothrombotic risk factors, have been reported in infants with perinatal stroke (PS). Rotation thromboelastometry (ROTEM) can analyze the coagulation system, from the beginning of coagulation, through clot formation, and ending with fibrinolysis. The aim of this study was to evaluate the hypercoagulability state in PAIS patients using ROTEM...
August 11, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Frederik Denorme, Tine Wyseure, Miet Peeters, Nele Vandeputte, Ann Gils, Hans Deckmyn, Karen Vanhoorelbeke, Paul J Declerck, Simon F De Meyer
BACKGROUND AND PURPOSE: Cerebral ischemia and reperfusion is associated with activation of the coagulation cascade and fibrin deposition in cerebral microvessels. Both thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen activator inhibitor-1 (PAI-1) attenuate fibrinolysis and are therefore attractive targets for the treatment of ischemic stroke. METHODS: TAFI and PAI-1 were inhibited by monoclonal antibodies in a mouse model of transient middle cerebral artery occlusion...
September 2016: Stroke; a Journal of Cerebral Circulation
C García-Cabo, L Benavente, J Martínez-Ramos, Á Pérez-Álvarez, A Trigo, S Calleja
INTRODUCTION: Prehospital code stroke (CS) systems have been proved effective for improving access to specialised medical care in acute stroke cases. They also improve the prognosis of this disease, which is one of the leading causes of death and disability in our setting. The aim of this study is to analyse results one year after implementation of the new code stroke protocol at one hospital in Asturias. PATIENTS AND METHODS: We prospectively included patients who were admitted to our tertiary care centre as per the code stroke protocol for the period of one year...
July 25, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Fernando Pico, Charlotte Rosso, Elena Meseguer, Marie-Laure Chadenat, Amina Cattenoy, Philippe Aegerter, Sandrine Deltour, Jennifer Yeung, Hassan Hosseini, Yves Lambert, Didier Smadja, Yves Samson, Pierre Amarenco
RATIONALE: Remote ischemic per-conditioning-causing transient limb ischemia to induce ischemic tolerance in other organs-reduces final infarct size in animal stroke models. AIM: To evaluate whether remote ischemic per-conditioning during acute ischemic stroke (<6 h) reduces brain infarct size at 24 h. METHODS AND DESIGN: This study is being performed in five French hospitals using a prospective randomized open blinded end-point design...
July 13, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Marie-Christine Alessi, Christophe Gaudin, Philippe Grosjean, Valérie Martin, Serge Timsit, Marie-Hélène Mahagne, Vincent Larrue, Igor Sibon, Mathieu Zuber, Raf Brouns, Joan Montaner, Mar Castellanos, Yves Donazzolo, Tae-Hee Cho, Laurent Suissa, Laura Mechtouff, Laurent Derex, Pierre Suchon, Anna Mezzapesa, Norbert Nighoghossian
BACKGROUND AND PURPOSE: Thrombin-activatable fibrinolysis inhibitor (TAFI) activation following thrombolysis may affect thrombolysis effectiveness in acute ischemic stroke (AIS). To support this hypothesis, we propose to study the relationship between TAFI consumption, activated/inactivated TAFI (TAFIa/ai) and stroke severity and outcome in 2 groups of AIS patients, one treated and one untreated with intravenous recombinant tissue type plasminogen activator (rt-PA). METHODS: In this prospective, longitudinal, multicenter, observational study, we aimed to study the association between TAFIa/ai and stroke outcome...
July 8, 2016: Cerebrovascular Diseases
R L Medcalf
No abstract text is available yet for this article.
September 2016: Journal of Thrombosis and Haemostasis: JTH
Annie Pedersen, Petra Redfors, Linnea Lundberg, Ann Gils, Paul J Declerck, Staffan Nilsson, Katarina Jood, Christina Jern
Ischaemic stroke patients continue to be at risk for recurrent vascular events for many years. Predictors of long-term prognosis are needed. It was the objective of this study to investigate levels of four haemostatic proteins as long-term predictors of recurrent vascular events after ischaemic stroke. We prospectively followed 548 ischaemic stroke patients, 18-69 years, and registered recurrent vascular events. Plasma levels of tissue-type plasminogen activator (t-PA), von Willebrand factor (VWF), fibrinogen and thrombin activatable fibrinolysis inhibitor activation peptide (TAFI-AP) were measured three months after index stroke...
August 30, 2016: Thrombosis and Haemostasis
Yanling Wang, Adam Hafeez, Fanhua Meng, Ruihua Zhang, Xuemei Wang, Xiaomeng Chen, Qi Kong, Huishan Du, Xin Ma
OBJECTIVE: To investigate the correlation between nerve function defect, their degree of recovery, and D-dimer levels in patients with acute ischemic cerebrovascular disease (AICVD) complicating coronary heart disease (CHD) in winter. METHODS: From 1 October, 2014 to 31 December, 2014, we enrolled patients in a consecutive manner with AICVD who were hospitalized in the Department of Neurology, Beijing Luhe hospital, Capital Medical University. The patients were selected that had an occurrence of AICVD within the last 14 days...
June 2016: Neurological Research
S Singh, A K Houng, D Wang, G L Reed
UNLABELLED: Essentials Physiologic variations in blood plasminogen (Pg) levels may affect ischemic stroke outcomes. We tested Pg effects in a model with translational relevance to human thromboembolic stroke. A dose-response exists between Pg levels and brain injury, fibrinolysis, barrier breakdown. Higher Pg levels reduce microvascular thrombosis and improve outcomes in ischemic stroke. SUMMARY: Background and Objectives Plasminogen appears to affect brain inflammation, cell movement, fibrinolysis, neuronal excitotoxicity, and cell death...
September 2016: Journal of Thrombosis and Haemostasis: JTH
J Marta Moreno, M Bestué Cardiel, A Giménez Muñoz, M Palacín Larroy
INTRODUCTION: In 2008, stroke mortality, morbidity, and disability rates in Aragon were higher than the average in Spain. These data underscored the need to develop a stroke care programme (PAIA). MATERIAL AND METHODS: We present the dynamics of planning, implementation, evaluation, and improvement developed between 2009 and 2014 as well as the results of the PAIA after that 5-year period. RESULTS: Structure, processes, and outcomes have improved with reference to the key indicators of healthcare (audit: 2008, 2010, 2012) among others: stroke rate in 2013 was 2...
June 14, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Seunguk Jung, Cheolkyu Jung, Yun Jung Bae, Byung Se Choi, Jae Hyoung Kim, Sang-Hwa Lee, Jun Young Chang, Beom Joon Kim, Moon-Ku Han, Hee-Joon Bae, Bae Ju Kwon, Sang-Hoon Cha
BACKGROUND AND PURPOSE: Recent advances in intra-arterial techniques and thrombectomy devices lead to high rate of recanalization. However, little is known regarding the effect of the evolvement of endovascular revascularization therapy (ERT) in acute basilar artery occlusion (BAO). We compared the outcome of endovascular mechanical thrombectomy (EMT) versus intra-arterial fibrinolysis (IAF)-based ERT in patients with acute BAO. METHODS: After retrospectively reviewed a registry of consecutive patients with acute ischemic stroke who underwent ERT from September 2003 to February 2015, 57 patients with acute BAO within 12 hours from stroke onset were enrolled...
May 2016: Journal of Stroke
Márcio Madeira, Catarina Martins, Giovanna Koukoulis, Marta Marques, João Reis, Miguel Abecassis
Stroke after cardiac surgery remains a devastating complication and its treatment options are limited. Systemic fibrinolysis is a relative contraindication, because it raises the risk of systemic hemorrhage. Endovascular therapy, mechanical thrombectomy, and intra-arterial fibrinolysis have emerged as safer options. We present three patients who developed strokes following cardiac surgery who underwent successful mechanical thrombectomy and review the literature on this subject. doi: 10.1111/jocs.12776 (J Card Surg 2016;31:517-520)...
August 2016: Journal of Cardiac Surgery
Pravesh Kumar Bundhun, Girish Janoo, Meng-Hua Chen
From the year 1986 onwards, several studies have been published focusing on the comparison between fibrinolysis and primary percutaneous coronary intervention (PPCI) in patients with ST segment elevated myocardial infarction (STEMI). However, because antiplatelet and anticoagulating medications are used in approximation, before and during these procedures, bleeding events have been reported to be associated with both reperfusion therapies. This study aimed to compare the bleeding events associated with fibrinolytic therapy and primary angioplasty in patients with STEMI...
June 2016: Medicine (Baltimore)
Marija Vavlukis, Irina Kotlar, Emilija Chaparoska, Bekim Pocesta, Hristo Pejkov, Marjan Boshev, Sasko Kedev
AIM: We are presenting an uncommon case of pulmonary embolism, followed with an acute myocardial infarction, in a patient with progressive systemic sclerosis. CASE PRESENTATION: A female 40 years of age was admitted with signs of pulmonary embolism, confirmed with CT scan, which also reviled a thrombus in the right ventricle. The patient had medical history of systemic sclerosis since the age of 16 years. She suffered an ischemic stroke 6 years ago, but she was not taking any anticoagulant or antithrombotic medications ever since...
December 15, 2015: Open Access Maced J Med Sci
Sabrina Anticoli, Maria Cristina Bravi, Giovanni Perillo, Antonio Siniscalchi, Claudio Pozzessere, Francesca Romana Pezzella, Piero Tanzi, Luca Gallelli, Domenico Cartoni
Previous clinical studies suggest that intravenous (IV) recombinant tissue plasminogen activator (rt-PA) benefits stroke patients regardless of the underlying etiology. In this study, we assessed the possible differences in response to IV rt-PA between cardioembolic stroke and other stroke subtypes. A total of 303 consecutive stroke ischemic patients (from January 2005 to April 2014) admitted to our Stroke Unit and treated with IV rt-PA were retrospectively reviewed. All patients were classified in two groups: Cardioembolic (CE) and Non-Cardioembolic (NCE)...
2016: Current Neurovascular Research
Ahmed Alhusban, Anna Kozak, Wael Eldashan, Adviye Ergul, Susan C Fagan
BACKGROUND: Blood flow restoration with fibrinolysis and thrombectomy is recommended to limit injury in stroke patients with proximal artery occlusion. Angiotensin receptor blockers have been shown to be neuroprotective in models of permanent and temporary occlusion, but the benefits on expression of trophic factors have been seen only when the artery is reopened. It is possible that early artery opening with endovascular intervention may increase the likelihood of identifying an effective combination therapy for patients...
2016: Experimental & Translational Stroke Medicine
Yee Cheng Lau, Qinmei Xiong, Gregory Y H Lip, Andrew D Blann
OBJECTIVE: Atrial fibrillation (AF) brings a risk of thrombosis, requiring oral coagulation, and is associated with renal impairment. The two processes may be linked, as altered fibrin clot structure is present in end-stage renal failure. We hypothesised that progressively deteriorating renal function is linked to altered whole blood and fibrin clot properties and fibrinolysis. METHODS: Thrombogenesis and fibrinolysis in 200 warfarinised AF patients was assessed by thromboelastography (TEG), a micro-plate assay (MPA) and the international normalized ratio (INR)...
2016: Annals of Medicine
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