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Intra-arterial thrombolysis

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https://www.readbyqxmd.com/read/29780944/central-retinal-artery-occlusion-secondary-to-barlow-s-disease
#1
Carl S Wilkins, Katherine McCabe, Avnish Deobhakta, James Chelnis
Purpose: To report a rare case of isolated, unilateral CRAO in a young patient with mitral valve prolapse secondary to Barlow's disease. Observations: A 29-year-old woman with history of premature ventricular contractions and cardiac ablation presented to the emergency room after sudden onset painless visual loss in her left eye (OS). Her vision was 20/20 in her right eye and hand motion in the left. Fundus exam demonstrated a central retinal artery occlusion (CRAO) OS...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29771445/tirofiban-combined-with-rt-pa-intraarterial-thrombolysis-improves-the-recanalization-rate-of-acute-middle-cerebral-artery-occlusion-in-rabbits
#2
Y-J Yu, W Xiong
OBJECTIVE: To investigate the curative effect of tirofiban combined with recombinant tissue-plasminogen activator (rt-PA) selective intra-arterial thrombolysis on acute middle cerebral artery occlusion (MCAO). MATERIALS AND METHODS: A total of 60 adult male Japanese white rabbits weighing 2.5-3.0 kg were selected, and the acute cerebral infarction model was established via autologous thromboembolism of middle cerebral artery. Rabbits were randomly divided into 4 groups: tirofiban group (Ti group, 5 μg/kg, n=15), rt-PA group (rt-PA group, 2 mg/kg, n=15), tirofiban + rt-PA group (Ti + rt-PA group, 3 μg/kg Ti + 1 mg/kg rt-PA, n=15), and control group (Co group, n=15)...
May 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29724190/association-between-different-acute-stroke-therapies-and-development-of-post-stroke-seizures
#3
Jillian Naylor, Arthur Thevathasan, Leonid Churilov, Ruibing Guo, Yunyun Xiong, Miriam Koome, Ziyi Chen, Ziyuan Chen, Xinfeng Liu, Patrick Kwan, Bruce C V Campbell
BACKGROUND: Epilepsy is a major complication of stroke. We aimed to establish whether there is an association between intravenous thrombolysis, intra-arterial thrombolysis and post stroke seizure (PSS) development. Improved understanding of the relationship between reperfusion therapies and seizure development may improve post-stroke monitoring and follow-up. METHODS: This was a retrospective, multicentre cohort study conducted at the Royal Melbourne Hospital and Jingling Hospital Nanjing...
May 3, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29719551/importance-of-reperfusion-status-after-intra-arterial-thrombectomy-for-prediction-of-outcome-in-anterior-circulation-large-vessel-stroke
#4
Luuk Dekker, Victor J Geraedts, Hajo Hund, Suzanne C Cannegieter, Raul G Nogueira, Mayank Goyal, Ido R van den Wijngaard
Background: Reperfusion status after intra-arterial thrombectomy (IAT) is a critical predictor of functional outcome after acute ischemic stroke. However, most prognostic models have not included a detailed assessment of reperfusion status after IAT. Objective: The aim of this work was to assess the association between successful reperfusion and clinical outcome. Methods: Clinical, radiological, and procedural variables of patients treated with IAT were extracted from our prospective stroke registry...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29701341/outcomes-after-catheter-direct-thrombolysis-for-acute-limb-ischaemia-single-center-experience
#5
Tiago Soares, João Rocha Neves, Ricardo Castro Ferreira, Pedro Almeida, Paulo Dias, Sérgio Sampaio, José Fernando Teixeira
INTRODUCTION: The aim of this study is to evaluate the outcome of catheter directed thrombolysis (CDT) in acute lower limb ischaemia depending on the underlying etiology. METHODS: Retrospective single center analysis of electronic clinical data on patients with acute lower limb ischaemia treated with CDT. Between January 2011 and September 2017, 128 procedures in 106 patients were included. The etiology of ischaemia was native artery thrombosis in 39 procedures (30,5%), PTFE graft thrombosis in 56 (43,8%), intra-stent thrombosis in 11 (8,6%), emboly in 9 (7%), popliteal aneurysm thrombosis in 9 (7%), vein graft thrombosis in 2 (1,6%) and popliteal artery entrapment in 2 (1,6%)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29668339/in-hospital-outcomes-after-rotational-atherectomy-in-patients-with-low-ejection-fraction
#6
Yusuke Watanabe, Toru Naganuma, Hiroyoshi Kawamoto, Hisaaki Ishiguro, Sunao Nakamura
OBJECTIVES: This study evaluated angiographic success and in-hospital outcomes of percutaneous coronary intervention (PCI) with rotational atherectomy (RA) in patients with low left ventricular ejection fraction (LVEF). DESIGN: Between January 2010 and March 2014, 272 consecutive patients with heavily calcified lesions underwent elective PCI with RA. Of these, 33 patients had LVEF ≤35% (low LVEF group), whereas 237 patients had LVEF >35% (preserved LVEF group)...
April 18, 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29629522/the-influence-of-sex-in-stroke-thrombolysis-a-systematic-review-and-meta-analysis
#7
REVIEW
Mingsu Liu, Guangqin Li, Jie Tang, Yan Liao, Lin Li, Yang Zheng, Tongli Guo, Xin Kang, Maoting Yuan
BACKGROUND AND PURPOSE: There is increasing recognition of the importance of stroke in females to both clinical and public health. The natural course of stroke is worse in females than in males, but the evidence regarding sex disparities in the responses to thrombolysis in stroke patents is still controversial. We compared outcomes after thrombolysis treatment between females and males. METHODS: Clinical trials reported in the Embase, PubMed, and Cochrane Library electronic databases up to March 13, 2017 were included in this analysis...
April 2018: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/29571862/emergent-carotid-artery-stenting-in-atherosclerotic-disease-of-the-internal-carotid-artery-with-tandem-intracranial-occlusion
#8
Marta Rodrigues, André Cunha, Sofia Figueiredo, Andreia Carvalho, Miguel Veloso, Pedro Barros, Tiago Gregório, Ludovina Paredes, João Pinho, Sérgio Castro, Manuel Ribeiro
BACKGROUND: Several randomized clinical trials have proven the safety and efficacy of mechanical thrombectomy (MT) in large vessel occlusions; nonetheless, there is still no consensus concerning hyperacute management of tandem occlusions. Recent studies have suggested that emergent carotid artery stenting (eCAS), along with mechanical thrombectomy, is an effective and safe treatment option. AIMS: To characterize the safety and short-term outcome of patients treated with eCAS during endovascular treatment of acute ischaemic stroke...
April 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29527185/intra-arterial-thrombolysis-for-acute-central-retinal-artery-occlusion-a-systematic-review-and-meta-analysis
#9
Paul S Page, Nicolas K Khattar, Andrew C White, Alexander C Cambon, Guy N Brock, Shesh N Rai, Robert F James
Background and purpose: Acute central retinal artery occlusion (CRAO) is a serious ophthalmologic emergency that may result in monocular blindness. To date, studies evaluating intra-arterial thrombolysis (IAT) have not shown a definitive clinical benefit. We have conducted a systematic review with a meta-analysis to effectively evaluate this treatment option. Methods: A systematic literature search was focused on studies containing five or more patients undergoing IAT that included a control group treated with standard therapy...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29505787/thrombolytic-therapies-for-ischemic-stroke-triumphs-and-future-challenges
#10
REVIEW
Aimen Moussaddy, Andrew M Demchuk, Michael D Hill
Acute stroke therapy has significantly evolved over the last two decades. The two main advances have been the approval of intravenous chemical thrombolysis in 1995, and the approval of intra-arterial mechanical thrombectomy in 2015. This has led to significant improvement of functional outcomes in a disease known to be the first cause of disability worldwide. Subsequent studies have focused on identifying pre-treatment predictors of good treatment candidates, by developing biochemical and imaging biomarkers...
March 3, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29471828/a-delphi-study-and-ranking-exercise-to-support-commissioning-services-future-delivery-of-thrombectomy-services-in-england
#11
Kristoffer Halvorsrud, Darren Flynn, Gary A Ford, Peter McMeekin, Ajay Bhalla, Joyce Balami, Dawn Craig, Phil White
BACKGROUND: Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets...
February 22, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29468288/efficacy-of-mechanical-thrombectomy-using-stent-retriever-and-balloon-guiding-catheter
#12
S Kammerer, R du Mesnil de Rochemont, M Wagner, S -J You, S Tritt, M Mueller-Eschner, F C Keil, A Lauer, J Berkefeld
PURPOSE: Intra-arterial therapy of acute ischemic stroke has developed rapidly in recent years. Due to proven efficacy in randomized trials, stent retrievers were replacing first-generation thrombectomy devices and have been defined as method of choice. However, aspiration catheters or a combination of several techniques have shown promising rates of successful recanalizations. To create a basis for comparison of the new approaches according to real-world data, we determined the first pass recanalization rate of an evidence-based standard technique with the use of a stent retriever in combination with a balloon-guiding catheter...
May 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29436201/infarct-core-expansion-on-computed-tomography-before-and-after-intravenous-thrombolysis
#13
Dongbeom Song, Joonsang Yoo, Jang Hyun Baek, Jinkwon Kim, Hye Sun Lee, Young Dae Kim, Hyo Suk Nam, Ji Hoe Heo
PURPOSE: Infarct core can expand rapidly in acute stroke patients receiving intravenous tissue plasminogen activator (IV t-PA). We investigated changes in the extent of infarct core during IV t-PA treatment, and explored the associative factors of this infarct core expansion in patients with proximal artery occlusion. MATERIALS AND METHODS: We included patients who were considered for sequential intra-arterial therapy (IAT) due to occlusion of intracranial proximal artery after IV t-PA...
March 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29387626/clinical-results-of-the-intra-arterial-thrombolysis-with-stent-retriever-device-weather-perfusion-diffusion-mismatching-and-intravenous-tissue-plasminogen-activator-administration
#14
Young-Jin Kim, Kwang-Wook Cho, Seong-Rim Kim, Do-Sung Yoo, Hae-Kwan Park, Cheol Ji
Objective: Intraarterial thrombolysis (IA-Tx) with stent retriever is accepted as an additional treatment for selected patients and the clinical benefit is well reported. Each intravenous tissue plasminogen activator administration (IV-tPA) and perfusion diffusion mismatching (P/D-mismatching) is well known the beneficial effects for recanalization and clinical outcomes. In this report, authors analyzed the clinical outcomes of additional IA-Tx with retrieval stent device, according to the combined IV-tPA and P/D-mismatching or not...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29381979/multiple-arterial-thromboses-due-to-cystic-medial-degeneration-erdheim-gsell-a-case-report
#15
Philipp Jud, Thomas Gary, Franz Hafner, Kurt Tiesenhausen, Thomas Ott, Wolfgang Kurt Oswald, Marianne Brodmann
RATIONALE: Cystic medial degeneration Erdheim-Gsell is a vascular pathology mainly of the large vessels, which is mostly associated with Marfan syndrome or Ehlers-Danlos syndrome. The clinical findings of this entity are aneurysms of the aorta or large peripheral arteries which usually present in an acute setting due to rupture of an aneurysm. PATIENT CONCERNS: We present a case of a 43-year-old Caucasian male with histologically proven cystic medial degeneration of the lower limb vessels mimicking peripheral artery occlusive disease...
November 2017: Medicine (Baltimore)
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
#16
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/29282332/collateral-response-modulates-the-time-penumbra-relationship-in-proximal-arterial-occlusions
#17
Smriti Agarwal, Andrew Bivard, Elizabeth Warburton, Mark Parsons, Christopher Levi
OBJECTIVE: While clinical benefit from thrombolysis decreases with increase in time from stroke onset, the relationship of acute physiologic tissue compartments and collateral response to stroke onset time remains unclear. METHODS: We studied consecutive patients with proximal arterial occlusions (n = 355) with whole-brain perfusion CT with CT angiography within 6 hours of stroke onset. Penumbra and core were defined using voxel-based thresholds. Tissue mismatch was defined as the ratio of penumbra to core...
January 23, 2018: Neurology
https://www.readbyqxmd.com/read/29208189/enlightenment-and-lesson-from-the-successful-treatment-of-acute-superior-mesenteric-artery-embolism
#18
Bei Wang, Rongju Sun, Wei Chen, Tanshi Li
 Despite recent advances, treatment of acute superior mesenteric artery embolism (SMAE) in emergency is still very difficult. The comparative rarity, the difficulty of early diagnosis, and the extremely high mortality of SMAE give us the sufficient reasons to report our successful experience in curing a patient with acute SMAE. In the present case, the patient was diagnosed early without evidence of intestinal necrosis. The diagnosis of SMAE was verified by computed tomography angiography (CTA). A comprehensive treatment was immediately employed including a combination of intra-arterial thrombolysis and embolectomy operation with emergent laparotomy...
November 30, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29176266/fibrin-clot-architecture-in-acute-ischemic-stroke-treated-with-mechanical-thrombectomy-with-stent-retrievers-cohort-study
#19
Dagmar Krajíčková, Antonín Krajina, Ivo Šteiner, Oldřich Vyšata, Roman Herzig, Miroslav Lojík, Vendelín Chovanec, Jan Raupach, Ondřej Renc, Jan Waishaupt, Eva Vítková, Petr Dulíček, Pavla Čabelková, Martin Vališ
BACKGROUND: The composition of intra-arterial clots might influence the efficacy of mechanical thrombectomy (MT) in ischemic stroke (IS) due to the acute occlusions within large cerebral arteries. The aims were to assess the factors associated with blood clot structure and the impact of thromboembolus structure on MT using stent-retrievers in patients with acute large artery IS in the anterior circulation.Methods and Results:In an observational cohort study, we studied the components of intra-arterial clots retrieved from large cerebral arteries in 80 patients with acute IS treated with MT with or without i...
February 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29167386/ischemic-stroke-profile-risk-factors-and-outcomes-in-india-the-indo-us-collaborative-stroke-project
#20
MULTICENTER STUDY
P N Sylaja, Jeyaraj Durai Pandian, Subhash Kaul, M V Padma Srivastava, Dheeraj Khurana, Lee H Schwamm, Praveen Kesav, Deepti Arora, Aman Pannu, Tijy K Thankachan, Aneesh B Singhal
BACKGROUND AND PURPOSE: The Indo-US Collaborative Stroke Project was designed to characterize ischemic stroke across 5 high-volume academic tertiary hospitals in India. METHODS: From January 2012 to August 2014, research coordinators and physician coinvestigators prospectively collected data on 2066 patients with ischemic stroke admitted <2 weeks after onset. Investigator training and supervision and data monitoring were conducted by the US site (Massachusetts General Hospital, Boston)...
January 2018: Stroke; a Journal of Cerebral Circulation
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