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https://www.readbyqxmd.com/read/29326820/a-case-of-intra-arterial-thrombolysis-with-alteplase-in-a-patient-with-hypothenar-hammer-syndrome-but-without-underlying-aneurysm
#1
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29303833/alteplase-administration-recommendations-for-inpatients-on-low-molecular-weight-heparin
#2
Sarah L Livesay
No abstract text is available yet for this article.
February 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29303832/alteplase-administration-recommendations-for-inpatients-on-low-molecular-weight-heparin
#3
Jenae Chamberlain, Ann Allison
No abstract text is available yet for this article.
February 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29302990/relevance-of-the-updated-food-and-drug-administration-alteplase-label-for-acute-ischemic-stroke-the-estimated-impact-and-current-guidelines
#4
Harn J Shiue, Karen C Albright, Kara A Sands
In 2015, the Food and Drug Administration updated the contraindications for the use of alteplase in acute ischemic stroke (AIS), potentially creating a greater impact on treatment. A history of intracranial hemorrhage and recent stroke within 3 months were removed as contraindications, increasing the number of patients eligible for alteplase. The aim of this commentary is to call attention to the updates and discuss them relative to current American Heart Association/American Stroke Association guidelines. Additionally, we estimate the clinical impact of the updates by analyzing AIS admissions to a large-volume Comprehensive Stroke Center...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29284355/stability-of-sodium-bicarbonate-injection-8-4-in-syringes-over-a-six-week-period-in-refrigerated-temperature
#5
Jack T Seki, Tian Q Wang, Paul M Yip, Tony Mazzulli, Mark D Minden
Background Dysfunctional central venous catheter prohibits the administration of potential life-saving chemotherapy and the delivery of essential supportive care needs to patients. Sodium bicarbonate injection has been shown to impede against fibrin clot formation and prolong prothrombin time and thrombin clotting time. Sodium bicarbonate injection has been tried as a second-line agent with good results in a small number of patients (internal data not published) when alteplase failed. We assessed whether the pre-filled sodium bicarbonate injection in 5 mL syringes would not only preserve sterility and retain its pH and concentration but also amount to the potential cost savings for future use when stored in a refrigerated environment...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29274443/gynecologic-bleeding-complications-in-post-menarchal-adolescent-females-on-anti-thrombotic-medications
#6
Heather Soni, Jennifer Kurkowski, Danielle Guffey, Jennifer E Dietrich, Lakshmi V Srivaths
INTRODUCTION: The prevalence, clinical features and management of gynecologic bleeding complications and health care provider awareness of these in post-menarchal adolescents on anti-thrombotic medications has rarely been addressed in the literature. We sought to review our experience in a pediatric tertiary care center addressing these issues. MATERIALS AND METHODS: A retrospective chart review was conducted with Institutional Review Board approval from 2004-2014, on eligible post-menarchal adolescents on antithrombotic medications...
December 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29262432/spontaneous-intraventricular-hemorrhage-when-should-intraventricular-tpa-be-considered
#7
Peter A Abdelmalik, Wendy C Ziai
Spontaneous intracerebral hemorrhage (ICH) is the most common cause of intraventricular hemorrhage (IVH) in adults. Complicating approximately 40% of ICH cases, IVH adds to the morbidity and mortality of this often fatal form of stroke. It is also a severity factor that complicates subarachnoid hemorrhage and traumatic brain injury, along with other less common causes of intracranial bleeding. Medical and surgical interventions to date have focused on limiting ICH and IVH expansion, controlling intracranial pressure, and relieving obstructive hydrocephalus...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29259732/edaravone-a-synthetic-free-radical-scavenger-enhances-alteplase-mediated-thrombolysis
#8
Kiyoshi Kikuchi, Kentaro Setoyama, Ko-Ichi Kawahara, Tomoka Nagasato, Takuto Terashi, Koki Ueda, Kazuki Nakanishi, Shotaro Otsuka, Naoki Miura, Hisayo Sameshima, Kazuya Hosokawa, Yoichiro Harada, Binita Shrestha, Mika Yamamoto, Yoko Morimoto-Yamashita, Haruna Kikuchi, Ryoji Kiyama, Chinatsu Kamikokuryo, Salunya Tancharoen, Harutoshi Sakakima, Motohiro Morioka, Eiichiro Tanaka, Takashi Ito, Ikuro Maruyama
The combination of alteplase, a recombinant tissue plasminogen activator, and edaravone, an antioxidant, reportedly enhances recanalization after acute ischemic stroke. We examined the influence of edaravone on the thrombolytic efficacy of alteplase by measuring thrombolysis using a newly developed microchip-based flow-chamber assay. Rat models of embolic cerebral ischemia were treated with either alteplase or alteplase-edaravone combination therapy. The combination therapy significantly reduced the infarct volume and improved neurological deficits...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29247142/novel-telestroke-program-improves-thrombolysis-for-acute-stroke-across-21-hospitals-of-an-integrated-healthcare-system
#9
Mai N Nguyen-Huynh, Jeffrey G Klingman, Andrew L Avins, Vivek A Rao, Abigail Eaton, Sunil Bhopale, Anne C Kim, John W Morehouse, Alexander C Flint
BACKGROUND AND PURPOSE: Faster treatment with intravenous alteplase in acute ischemic stroke is associated with better outcomes. Starting in 2015, Kaiser Permanente Northern California redesigned its acute stroke workflow across all 21 Kaiser Permanente Northern California stroke centers to (1) follow a single standardized version of a modified Helsinki model and (2) have all emergency stroke cases managed by a dedicated telestroke neurologist. We examined the effect of Kaiser Permanente Northern California's Stroke EXpediting the PRrocess of Evaluating and Stopping Stroke program on door-to-needle (DTN) time, alteplase use, and symptomatic intracranial hemorrhage rates...
December 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29246609/safety-and-preliminary-efficacy-of-intravenous-tirofiban-in-acute-ischemic-stroke-patient-without-arterial-occlusion-on-neurovascular-imaging-studies
#10
Lu Lin, Wei Li, Cheng-Chun Liu, Ya Wu, Shu-Han Huang, Xiao-Shu Li, Chun-Rong Liang, Huan Wang, Li-Li Zhang, Zhi-Qiang Xu, Yan-Jiang Wang, Wuwei Feng, Meng Zhang
BACKGROUND: There has been no effective treatment for acute ischemic stroke (AIS) patients who presented to the Emergency Department >4.5h without a visible arterial occlusion on the neurovascular imaging studies. In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study...
December 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29243573/corrigendum-to-effects-of-alteplase-for-acute-stroke-according-to-criteria-defining-the-european-union-and-united-states-marketing-authorizations-individual-patient-data-meta-analysis-of-randomized-trials
#11
(no author information available yet)
No abstract text is available yet for this article.
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29241193/comparative-analysis-on-low-and-standard-dose-regimes-of-alteplase-thrombolytic-therapy-for-acute-ischemic-stroke-efficacy-and-safety
#12
Guangjian Zhao, Tingfen Huang, Mei Zheng, Yansen Cui, Yunyong Liu, Zhongrong Cheng, Ziran Wang
OBJECTIVE: This study analyzed the efficacy and safety of low-dose and standard-dose alteplase intravenous thrombolytic therapy for acute ischemic stroke (AIS). METHODS: Patients with AIS who underwent intravenous alteplase thrombolysis from July 2012 to December 2016 were retrospectively analyzed and correspondingly divided into low-dose (0.6-0.89 mg/kg) group and standard-dose group (0.9 mg/kg) according to alteplase dosage. The clinical outcome was evaluated by modified Rankin Scale (mRS) at 90 days after onset...
December 14, 2017: European Neurology
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
#13
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...
December 11, 2017: 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%C3%A2-hours-versus-3-4-5%C3%A2-hours
#14
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...
December 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29221347/safe-administration-of-intrapleural-alteplase-during-pregnancy
#15
Heather Torbic, Hanine Inaty, Siva Raja, Humberto Choi
Instillation of intrapleural (IP) fibrinolytics has been used in patients with complicated parapneumonic pleural effusions to improve fluid drainage and decrease the need for surgical intervention. However, clinical trials have not included certain special populations such as pregnant females and there are currently no published case reports of this practice in this group. We describe the case of a 35-year-old female, G2P1 at 32 weeks of gestation, with a complicated pleural effusion due to influenza pneumonia with superimposed bacterial pneumonia...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29205466/ischemic-core-thresholds-change-with-time-to-reperfusion-a-case-control-study
#16
Andrew Bivard, Tim Kleinig, Ferdinand Miteff, Kenneth Butcher, Longting Lin, Christopher Levi, Mark Parsons
INTRODUCTION: We aimed to identify if acute ischemic stroke patients with known complete reperfusion after thrombectomy had the same baseline CTP ischemic core threshold to predict infarction as thrombolysis patients with complete reperfusion. METHODS: Patients who underwent thrombectomy were matched by age, clinical severity, occlusion location, and baseline perfusion lesion volume to patients who were treated with intravenous alteplase alone from the International Stroke Perfusion Imaging Registry...
December 4, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29196364/lesson-of-the-month-2-use-of-thrombolysis-for-ischaemic-stroke-in-pregnancy-a-case-report-and-review-of-literature
#17
Asim Khan, Paris Hosseini, Branimir Nevajda, Sami Khan
A nine-week pregnant 33-year-old female presented with sudden-onset right-sided hemiparesis, hemisensory loss, dysarthria and homonymous hemianopia. She was known to have eleven previous miscarriages and used recreational drugs. A CT-head was unremarkable. The patient was subsequently diagnosed with an acute thromboembolic infarct and chose alteplase after counselling. During thrombolysis an ultrasound identified a foetus with no concerning features.  A post-thrombolysis CT revealed a left-sided posterior cerebral infarct...
December 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29196200/incidental-thrombotic-thrombocytopenic-purpura-during-acute-ischemic-stroke-and-thrombolytic-treatment
#18
İbrahim Acır, Hacı Ali Erdoğan, Vildan Yayla, Nilay Taşdemir, Murat Çabalar
BACKGROUND: Intravenous tissue plasminogen activator (IV tPA) was shown to be an effective treatment for acute ischemic stroke (AIS). According to stroke guidelines, there is no need to wait for the complete blood count (CBC) and coagulation test results before application of IV alteplase if there is no suspected coagulation disorder. In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented. CASE: A 33-year-old male patient was admitted at the 2...
November 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29191741/thrombolytic-therapy-of-acute-ischemic-stroke-during-early-pregnancy
#19
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...
November 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29185557/frequency-determinants-and-effects-of-early-seizures-after-thrombolysis-for-acute-ischemic-stroke-the-enchanted-trial
#20
Ying Xu, Maree L Hackett, John Chalmers, Richard I Lindley, Xia Wang, Qiang Li, Thompson Robinson, Hisatomi Arima, Pablo M Lavados, Craig S Anderson
Background: Seizures after ischemic stroke have not been well-studied. We aim to determine the frequency, determinants, and significance of early seizures after thrombolysis for acute ischemic stroke. Methods: Data are from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED), an international, multicenter, randomized controlled trial where patients with acute ischemic stroke were randomized to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) IV alteplase...
August 2017: Neurology. Clinical Practice
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