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Intra-arterial thrombolysis

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https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#1
Enming Joseph Su, Chunzhang Cao, Linda Fredriksson, Ingrid Nilsson, Christina Stefanitsch, Tamara K Stevenson, Juanjuan Zhao, Margret Ragsdale, Yu-Yo Sun, Manuel Yepes, Chia-Yi Kuan, Ulf Eriksson, Dudley K Strickland, Daniel A Lawrence, Li Zhang
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα)...
July 19, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28721323/endovascular-management-of-stroke-patients-with-large-vessel-occlusion-and-minor-stroke-symptoms
#2
REVIEW
Saeed A Alqahtani, Andrew B Stemer, Michael F McCullough, Randy S Bell, Jeffrey Mai, Ai-Hsi Liu, Rocco A Armonda
Endovascular mechanical thrombectomy for stroke patients with large vessel occlusion (LVO) in the anterior circulation has become the standard of care based on several major randomized clinical trials. The successful result reported by these trials constitutes what may be the largest achievement in the history of neurological sciences. However, most of these mechanical thrombectomy trials (except for the multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands, i...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28705822/focal-low-and-global-high-permeability-predict-the-possibility-risk-and-location-of-hemorrhagic-transformation-following-intra-arterial-thrombolysis-therapy-in-acute-stroke
#3
Y Li, Y Xia, H Chen, N Liu, A Jackson, M Wintermark, Y Zhang, J Hu, B Wu, W Zhang, J Tu, Z Su, G Zhu
BACKGROUND AND PURPOSE: The contrast volume transfer coefficient (K(trans)), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation. MATERIALS AND METHODS: We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment...
July 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28702878/recent-trends-in-clot-retrieval-devices-a-review
#4
REVIEW
Aamir Hameed, Haroon Zafar, Darren Mylotte, Faisal Sharif
Stroke is the second leading cause of death worldwide and in Europe. Even with gold standard medical management of acute ischemic stroke, which is intravenous (IV) thrombolysis by administration of recombinant tissue plasminogen activator (rt-PA), the mortality rate remains the same. Intra-arterial (IA) thrombolysis therapy also did not achieve significant results and was not approved by the US Food and Drug Administration (FDA) because of limited sample size. This encouraged scientists and engineers to develop endovascular clot retrieval devices for the mechanical recanalization of the occluded arteries in stroke patients...
July 12, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28702681/intra-arterial-thrombolysis-for-extremity-frostbite-decreases-digital-amputation-rates-and-hospital-length-of-stay
#5
Nishant Patel, Dhivya R Srinivasa, Ravi N Srinivasa, Joseph J Gemmete, Venkat Krishnamurthy, Narasimham Dasika, Shilpa N Reddy, Matthew L Osher, Erika D Sears, Jeffrey Forris Beecham Chick
PURPOSE: To report outcomes of intra-arterial thrombolysis versus non-thrombolytic management of severe frostbite with respect to digital amputation rates and hospital length of stay (LOS). MATERIALS AND METHODS: Seventeen patients with severe frostbite were identified from 2000 to 2017. Eight (47%) patients with mean age of 40 years underwent intra-arterial thrombolysis and served as the treatment group. Nine (53%) patients with mean age of 53 years received non-thrombolytic management and served as the control group...
July 12, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28666803/intra-arterial-treatment-for-patients-with-severe-acute-vertebrobasilar-occlusion-a-single-center-retrospective-study
#6
Jie Cao, Jinggang Xuan, Ronghua Chen, Xucheng Zhu, Huaming Shao, Xiaofeng Chao, Feng Zhi, Naiyuan Shao, Ya Peng
BACKGROUND: Recently, favorable outcomes from several randomized controlled trials of rapid endovascular treatment for acute ischemic stroke has emerged. OBJECTIVE: The aim of this retrospective study is to present our clinical experience in severe acute vertebrobasilar occlusion (AVBO) using intra-arterial treatment (IAT). METHODS: Twenty patients with ischemic stroke in the vertebrobasilar circulation treated by IAT between March 2011 and December 2014 were included...
June 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#7
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28596447/impact-of-thrombus-length-on-outcomes-after-intra-arterial-aspiration-thrombectomy-in-the-therapy-trial
#8
RANDOMIZED CONTROLLED TRIAL
Albert J Yoo, Pooja Khatri, J Mocco, Osama O Zaidat, Rishi Gupta, Donald Frei, Demetrius Lopes, Harish Shownkeen, Olvert A Berkhemer, Denise Meyer, Susana S Hak, Sophia S Kuo, Hope Buell, Arani Bose, Siu Po Sit, Rüdiger von Kummer
BACKGROUND AND PURPOSE: Increasing thrombus length (TL) impedes recanalization after intravenous (IV) thrombolysis. We sought to determine whether the clinical benefit of aspiration thrombectomy relative to IV r-tPA (recombinant tissue-type plasminogen activator) may be greater at longer TL. METHODS: THERAPY was a randomized trial of aspiration thrombectomy plus IV r-tPA versus IV r-tPA alone in large-vessel stroke patients with prospective TL measurement ≥8 mm...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28596196/effect-of-retrievable-stent-size-on-endovascular-treatment-of-acute-ischemic-stroke-a-multicenter-study
#9
D Yang, Y Hao, W Zi, H Wang, D Zheng, H Li, M Tu, Y Wan, P Jin, G Xiao, Y Xiong, G Xu, X Liu
BACKGROUND AND PURPOSE: In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes. MATERIALS AND METHODS: Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28592785/multidisciplinary-approach-to-decrease-in-hospital-delay-for-stroke-thrombolysis
#10
Sang-Beom Jeon, Seung Mok Ryoo, Deok Hee Lee, Sun U Kwon, Seongsoo Jang, Eun-Jae Lee, Sang Hun Lee, Jung Hee Han, Mi Jeong Yoon, Soo Jeong, Young-Uk Cho, Sungyang Jo, Seung-Bok Lim, Joong-Goo Kim, Han-Bin Lee, Seung Chai Jung, Kye Won Park, Min-Hwan Lee, Dong-Wha Kang, Dae Chul Suh, Jong S Kim
BACKGROUND AND PURPOSE: Decreasing the time delay for thrombolysis, including intravenous thrombolysis (IVT) with tissue plasminogen activator and intra-arterial thrombectomy (IAT), is critical for decreasing the morbidity and mortality of patients experiencing acute stroke. We aimed to decrease the in-hospital delay for both IVT and IAT through a multidisciplinary approach that is feasible 24 h/day. METHODS: We implemented the Stroke Alert Team (SAT) on May 2, 2016, which introduced hospital-initiated ambulance prenotification and reorganized in-hospital processes...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28583459/a-retrospective-study-of-clinical-outcomes-after-endovascular-treatment-in-acute-ischemic-stroke-patients-with-complete-anterior-circulation-infarction-taci-in-the-absence-of-multimodal-ct
#11
Chenghua Xu, Anyang Tao, Peng Wang, Zhimin Wang, Yi Zhang, Xiaoxiao Tao, Huaping Xin, Xian Zheng, Jiangxian Ying
OBJECTIVE: To analyze the positive predictive value of large artery occlusion and clinical prognosis in acute ischemic stroke patients with total anterior circulation infarct (TACI) who underwent endovascular treatment in the absence of multimodal CT angiography (CTA)/ CT perfusion (CTP). METHODS: The inclusion criteria for the acute ischemic stroke patients to receive endovascular treatment were as the follows: the OCSP classification was TACI, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≥ 6, National Institutes of Health stroke scale (NIHSS) score ≥8, and within 4...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28546045/intravenous-targeted-microbubbles-carrying-urokinase-versus-urokinase-alone-in-acute-peripheral-arterial-thrombosis-in-a-porcine-model
#12
Johanna H Nederhoed, Harm P Ebben, Jeroen Slikkerveer, Arjan W J Hoksbergen, Otto Kamp, Geert-Jan Tangelder, Willem Wisselink, René J P Musters, Kak K Yeung
BACKGROUND: Standard therapy in acute peripheral arterial occlusion consists of intra-arterial catheter-guided thrombolysis. As microbubbles may be used as a carrier for fibrinolytic agents and targeted to adhere to the thrombus, we can theoretically deliver the thrombolytic medication locally following simple intravenous injection. In this intervention-controlled feasibility study, we compared intravenously administered targeted microbubbles incorporating urokinase and locally applied ultrasound, with intravenous urokinase and ultrasound alone...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28485774/the-clinical-study-on-the-treatment-for-acute-cerebral-infarction-by-intra-arterial-thrombolysis-combined-with-mild-hypothermia
#13
L-L Ma, L Song, X-D Yu, T-X Yu, H Liang, J-X Qiu, L Tan
OBJECTIVE: This study was purposed to evaluate the clinical efficacy of the treatment for acute cerebral infarction by intra-arterial thrombolysis combined with mild hypothermia. PATIENTS AND METHODS: Thirty patients, diagnosed with acute anterior circulation cerebral infarction and admitted to the Hospital between January 2013 and September 2015, were randomly divided into the control group and the mild hypothermia group, each group comprising 15 cases. The treatment of intra-arterial thrombolysis combined with mild hypothermia was administered to the mild hypothermia group, while only the treatment of intra-arterial thrombolysis was performed on the control group...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28483627/endovascular-treatment-with-primary-stenting-of-acutely-thrombosed-popliteal-artery-aneurysms
#14
Aaron Fargion, Fabrizio Masciello, Giovanni Pratesi, Elena Giacomelli, Walter Dorigo, Carlo Pratesi
PURPOSE: Only anecdotal cases concerning primary stenting of thrombosed popliteal artery aneurysm (PAA) without a preoperative intra-arterial thrombolysis are reported. We report our series of six patients treated with this technique. CASE REPORT: Six male patients, aged between 63 and 88, came to our attention in the last 10 years for acute limb ischemia due to thrombosis of a PAA. In all the cases immediate digital subtraction angiography (DSA) was performed, the occlusion was crossed with an angiographic guidewire and, once an adequate distal landing zone was identified in the distal popliteal artery, a primary stenting was performed...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28478979/risk-factors-and-stroke-characteristic-in-patients-with-postoperative-strokes
#15
Yi Dong, Wenjie Cao, Xin Cheng, Kun Fang, Xiaolong Zhang, Yuxiang Gu, Bing Leng, Qiang Dong
BACKGROUND: Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes...
July 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28435627/outcome-of-acute-ischemic-stroke-after-intra-arterial-thrombolysis-a-study-from-india
#16
Jaydip Ray Chaudhuri, Randhir Kumar, Matapathi Umamahesh, Kandadai Rukmini Mridula, Suvarnal Alladi, Srinivasarao Bandaru
Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is the currently standard treatment of acute ischemic stroke within 4.5 hours of the onset of stroke. Recent studies have looked at the benefits of administration of intra-arterial (IA) rt-PA within 8 hours onset of symptoms. Our objective was to assess the outcome of stroke after administration of IA rt-PA in patients with acute ischemic stroke. Methods: We recruited 10 consecutive acute ischemic stroke patients with onset of stroke from 4...
October 7, 2016: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28431023/safety-and-efficacy-of-the-sofia-6f-plus-distal-access-reperfusion-catheter-in-the-endovascular-treatment-of-acute-ischemic-stroke
#17
Hussain Shallwani, Hakeem J Shakir, Leonardo Rangel-Castilla, Jason M Davies, Ashish Sonig, Mithun G Sattur, Bernard R Bendok, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Neuroendovascular intervention has become a key treatment option for acute ischemic stroke. The Sofia (6F) PLUS catheter was designed for neurovascular access for diagnostic or therapeutic interventions. OBJECTIVE: To report the first series describing use of the Sofia PLUS intermediate/distal access reperfusion catheter in the treatment of acute ischemic stroke. METHODS: In this retrospective study, 41 stroke cases were identified in which the catheter was utilized for thrombolysis/thrombectomy...
April 19, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28429356/thrombolysis-in-acute-stroke-without-angiographically-documented-occlusion
#18
M-C Shi, F-N Chu, C Li, S-C Wang
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) using urokinase (UK) in acute stroke patients without angiographically-documented occlusion, and to define predictors of clinical outcome. PATIENTS AND METHODS: We analyzed clinical and radiological data of acute ischemic stroke patients whose angiography did not show an arterial occlusion within six hours of symptom onset and who were further treated with IAT using UK...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28427984/effect-of-baseline-characteristics-on-the-outcome-of-stent-retriever-based-thrombectomy-in-acute-basilar-artery-occlusions-a-single-center-experience-and-pooled-data-analysis
#19
Wan-Ling Wen, Zi-Fu Li, Yong-Wei Zhang, Peng-Fei Yang, Keith Simfukwe, Yi-Bin Fang, Tian-Yi Zhang, Ben-Qiang Deng, Bo Hong, Jian-Min Liu, Qing-Hai Huang
OBJECTIVES: -To explore the association of baseline characteristics and the outcome of acute basilar artery occlusion (BAO) patients following stent retriever based thrombectomy (SRT). METHODS: -Clinical and imaging information of consecutive SRT treated BAO patients from a comprehensive stroke center and up-to-date literatures were reviewed respectively. The impact of baseline variables towards favorable outcome was evaluated using subgroup analysis and odds ratio extracted from published data resource together with single center records using pooled analysis...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28400063/first-case-of-ischemic-stroke-which-happened-during-continuous-intravenous-infusion-of-rt-pa
#20
Anna Zurawska, Jaroslaw Czeczotka, Jacek J Rozniecki
Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus...
May 2017: Neurologia i Neurochirurgia Polska
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