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https://www.readbyqxmd.com/read/27904506/safety-and-efficacy-of-tenecteplase-versus-alteplase-in-acute-coronary-syndrome-a-systematic-review-and-meta-analysis-of-randomized-trials
#1
REVIEW
Alexandre Guillermin, David Jun Yan, Arnaud Perrier, Christophe Marti
INTRODUCTION: Alteplase and tenecteplase are two widely used thrombolytic agents and are both approved for the treatment of acute myocardial infarction. These two molecules have increased fibrin specificity compared with older thrombolytics but distinct pharmacokinetic properties and may differ in terms of risks and benefits. We decided to review the available evidence comparing the safety and efficacy of these two molecules in acute coronary syndrome (ACS) or pulmonary embolism (PE)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27900893/prompt-treatment-with-alteplase-is-essential-for-patients-with-severe-ischaemic-stroke
#2
(no author information available yet)
Thrombolysis with alteplase delivered within 4.5 hours of the onset of ischaemic stroke significantly improves the chances of good outcomes, but it also increases the risk of intracerebral haemorrhage, which can cause death or functional impairment.
November 30, 2016: Nursing Older People
https://www.readbyqxmd.com/read/27887792/edaravone-with-and-without-6%C3%A2-mg-kg-alteplase-within-4-5-hours-after-ischemic-stroke-a-prospective-cohort-study-protect4-5
#3
Takenori Yamaguchi, Hideto Awano, Hiroaki Matsuda, Norio Tanahashi
BACKGROUND: Edaravone is widely used to treat acute ischemic stroke (AIS) within 24 hours of onset. We aimed to evaluate current edaravone treatment practices and the efficacy and safety of edaravone used with recombinant tissue plasminogen activator (tPA) in AIS patients within 4.5 hours of onset. The results were compared with those of the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Registry (SITS-ISTR) study. METHODS: PROTECT4...
November 22, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#4
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27851466/1831-alteplase-for-ischemic-stroke-after-heparin-reversal-with-protamine
#5
Gabriel Fontaine, Shawn Smith
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849730/50-evaluation-of-half-dose-versus-full-dose-alteplase-for-treatment-of-pulmonary-embolism
#6
Tyree Kiser, Ellen Burnham, Brendan Clark, Michael Ho, Marc Moss, R Vandivier
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27834743/infarct-in-a-new-territory-after-treatment-administration-in-the-escape-randomized-controlled-trial-endovascular-treatment-for-small-core-and-anterior-circulation-proximal-occlusion-with-emphasis-on-minimizing-ct-to-recanalization-times
#7
Aravind Ganesh, Fahad S Al-Ajlan, Farahna Sabiq, Zarina Assis, Jeremy L Rempel, Kenneth Butcher, John Thornton, Peter Kelly, Daniel Roy, Alexandre Y Poppe, Tudor G Jovin, Thomas Devlin, Blaise W Baxter, Timo Krings, Leanne K Casaubon, Donald F Frei, Hana Choe, Donatella Tampieri, Jeanne Teitelbaum, Cheemun Lum, Jennifer Mandzia, Stephen J Phillips, Oh Young Bang, Mohammed A Almekhlafi, Shelagh B Coutts, Philip A Barber, Tolulope Sajobi, Andrew M Demchuk, Muneer Eesa, Michael D Hill, Mayank Goyal, Bijoy K Menon
BACKGROUND AND PURPOSE: Infarct in a new previously unaffected territory (INT) is a potential complication of endovascular treatment. We applied a recently proposed methodology to identify and classify INTs in the ESCAPE randomized controlled trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times). METHODS: The core laboratory identified INTs on 24-hour follow-up imaging, blinded to treatment allocation, after assessing all baseline imaging...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27831633/therapeutic-effect-of-tenecteplase-on-treatment-of-cerebral-arterial-thrombosis-a-meta-analysis
#8
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/27831547/recombinant-tissue-plasminogen-activator-to-restore-catheter-patency-efficacy-and-safety-analysis-from-a-multihospital-nicu-system
#9
D M Scott, C Y Ling, B C MacQueen, V L Baer, E Gerday, R D Christensen
OBJECTIVE: In 2001, the US Food and Drug Administration approved recombinant tissue plasminogen activator (alteplase, Cathflo Activase) to reestablish patency of central catheters occluded, presumably, by a fibrin clot. We conducted a multicenter quality improvement study to determine the value of this procedure in our Neonatal Intensive Care Unit (NICUs), including analyses of efficacy, safety and costs. STUDY DESIGN: We conducted a retrospective quality analysis of neonates in level III NICUs, who received alteplase for the purpose of reestablishing patency of occluded central catheters...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27784446/-effect-of-50-mg-alteplase-to-intermediate-risk-pulmonary-embolism-with-right-ventricular-dysfunction
#10
Q H Xu, W L Li, Z M Cai, Y C Lin, S P Huang
Objective: To investigate the effect of 50 mg alteplase to intermediate-risk acute pulmonary embolism (APE) with right ventricular dysfunction. Methods: From May 2011 to May 2015, a total of 73 patients with intermediate-risk APE, furthermore, right ventricular systolic pressure (RVSP)>40 mmHg and B-type natriuretic peptide (BNP)>100 ng/L, were allocated to receive 50 mg alteplase plus anti-coagulation (thrombolysis group, TG, n=35) or anticoagulation alone (control group CG, n=38) according to their will...
October 18, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27758945/uric-acid-therapy-prevents-early-ischemic-stroke-progression-a-tertiary-analysis-of-the-urico-ictus-trial-efficacy-study-of-combined-treatment-with-uric-acid-and-r-tpa-in-acute-ischemic-stroke
#11
Sergio Amaro, Carlos Laredo, Arturo Renú, Laura Llull, Salvatore Rudilosso, Víctor Obach, Xabier Urra, Anna M Planas, Ángel Chamorro
BACKGROUND AND PURPOSE: Identification of neuroprotective therapies in acute ischemic stroke is imperative. We report a predefined analysis of the URICO-ICTUS trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) assessing the efficacy of uric acid (UA) compared with placebo to prevent early ischemic worsening (EIW) and the relevance of collateral circulation. METHODS: URICO-ICTUS was a double-blind, placebo-controlled, phase 2b trial where a total of 411 patients treated with alteplase within 4...
November 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27756804/endovascular-therapy-for-acute-ischaemic-stroke-the-pragmatic-ischaemic-stroke-thrombectomy-evaluation-piste-randomised-controlled-trial
#12
Keith W Muir, Gary A Ford, Claudia-Martina Messow, Ian Ford, Alicia Murray, Andrew Clifton, Martin M Brown, Jeremy Madigan, Rob Lenthall, Fergus Robertson, Anand Dixit, Geoffrey C Cloud, Joanna Wardlaw, Janet Freeman, Philip White
OBJECTIVE: The Pragmatic Ischaemic Thrombectomy Evaluation (PISTE) trial was a multicentre, randomised, controlled clinical trial comparing intravenous thrombolysis (IVT) alone with IVT and adjunctive intra-arterial mechanical thrombectomy (MT) in patients who had acute ischaemic stroke with large artery occlusive anterior circulation stroke confirmed on CT angiography (CTA). DESIGN: Eligible patients had IVT started within 4.5 hours of stroke symptom onset. Those randomised to additional MT underwent thrombectomy using any Conformité Européene (CE)-marked device, with target interval times for IVT start to arterial puncture of <90 min...
October 18, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27751554/safety-and-efficacy-of-minimally-invasive-surgery-plus-alteplase-in-intracerebral-haemorrhage-evacuation-mistie-a-randomised-controlled-open-label-phase-2-trial
#13
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27750302/pooled-rcts-in-patients-with-acute-ischemic-stroke-alteplase-increases-intracerebral-hemorrhage
#14
Lucas McCarthy
No abstract text is available yet for this article.
October 18, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27729670/alteplase-and-tenecteplase-confusion-lack-of-e-prescribing-interoperability-leads-to-double-dosing-accidental-overdoses-involving-fluorouracil-infusions
#15
EDITORIAL
Michael R Cohen, Judy L Smetzer
These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27727305/no-impact-of-body-mass-index-on-outcome-in-stroke-patients-treated-with-iv-thrombolysis-bmi-and-iv-thrombolysis-outcome
#16
Meret Branscheidt, Juliane Schneider, Patrik Michel, Elissavet Eskioglou, Georg Kaegi, Robert Stark, Urs Fischer, Simon Jung, Marcel Arnold, Maria Wertli, Ulrike Held, Susanne Wegener, Andreas Luft, Hakan Sarikaya
BACKGROUND AND PURPOSE: The impact of excess body weight on prognosis after stroke is controversial. Many studies report higher survival rates in obese patients ("obesity paradox"). Recently, obesity has been linked to worse outcomes after intravenous (IV) thrombolysis, but the number and sample size of these studies were small. Here, we aimed to assess the relationship between body weight and stroke outcome after IV thrombolysis in a large cohort study. METHODS: In a prospective observational multicenter study, we analyzed baseline and outcome data of 896 ischemic stroke patients who underwent IV thrombolysis...
2016: PloS One
https://www.readbyqxmd.com/read/27677444/citation-bias-favoring-positive-clinical-trials-of-thrombolytics-for-acute-ischemic-stroke-a-cross-sectional-analysis
#17
Benjamin S Misemer, Timothy F Platts-Mills, Christopher W Jones
BACKGROUND: Citation bias occurs when positive trials involving a medical intervention receive more citations than neutral or negative trials of similar quality. Several large clinical trials have studied the use of thrombolytic agents for the treatment of acute ischemic stroke with differing results, thereby presenting an opportunity to assess these trials for evidence of citation bias. We compared citation rates among positive, neutral, and negative trials of alteplase (tPA) and other thrombolytic agents for stroke...
September 28, 2016: Trials
https://www.readbyqxmd.com/read/27666802/initial-experiences-with-endovascular-management-of-submassive-pulmonary-embolism-is-it-safe
#18
Timothy J Fuller, Christopher M Paprzycki, Muhammad H Zubair, Lala R Hussain, Brian A Kuhn, Matthew H Recht, Patrick E Muck
BACKGROUND: Interventional strategies for massive and submassive Pulmonary Embolism (smPE) have historically included either systematic intravenous thrombolytic alteplase (IV TPA) or surgical embolectomy, both of which are associated with significant morbidity and mortality. However, with the advent of endovascular techniques, recent studies have suggested that an endovascular approach to the treatment of acute smPE may be both safe and effective with excellent outcomes. The purpose of this study was to evaluate the outcomes of patients who have undergone catheter directed thrombolysis (CDT) for smPE at our institution in an effort to determine the safety of the procedure...
September 22, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27648019/clinical-efficacy-and-safety-of-hypernormal-shortened-door-to-needle-time-dnt-plus-individualized-low-dose-alteplase-therapy-in-treating-acute-ischemic-stroke
#19
Mei Zheng, Hongyan Lei, Yansen Cui, Daiqun Yang, Liquang Wang, Ziran Wang
OBJECTIVE: This study aims to observe the clinical efficacies of hyper-early low-dose alteplase thrombolysis in treating acute ischemic stroke (AIS). METHODS: Two hundred twenty AIS patients were randomly divided into group A (90 cases), group B (90 cases), and group C (40 cases). The National Institutes of Health Stroke Scale (NIHSS) scores, mRS score-evaluated prognosis, intracranial hemorrhage, and mortality of the three groups were observed before and after the treatment...
July 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27637676/stroke
#20
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
September 13, 2016: Lancet
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