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https://www.readbyqxmd.com/read/28732349/intracoronary-administration-of-tirofiban-during-percutaneous-coronary-intervention-facilitates-patients-with-acute-coronary-syndrome
#1
Helei Jia, Changqing Lu, Panli Sun
We assessed the efficacy and safety of tirofiban intracoronary versus intravenous administration during percutaneous coronary intervention for patients with acute coronary syndrome. The databases of PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang Database were retrieved. A total of 437 articles were found, according to inclusive and exclusive criteria, 13 of which were finally included. Compared with subjects with intravenous administration, those with intracoronary administration were more likely to reach thrombolysis in myocardial infarction trial grade 3 flow (relative risk = 1...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28731381/reperfusion-after-ischemic-stroke-is-associated-with-reduced-brain-edema
#2
Hannah J Irvine, Ann-Christin Ostwaldt, Matthew B Bevers, Simone Dixon, Thomas Wk Battey, Bruce Cv Campbell, Stephen M Davis, Geoffrey A Donnan, Kevin N Sheth, Reza Jahan, Jeffrey L Saver, Chelsea S Kidwell, W Taylor Kimberly
Rapid revascularization is highly effective for acute stroke, but animal studies suggest that reperfusion edema may attenuate its beneficial effects. We investigated the relationship between reperfusion and edema in patients from the Echoplanar Imaging Thrombolysis Evaluation Trial (EPITHET) and Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) cohorts. Reperfusion percentage was measured as the difference in perfusion-weighted imaging lesion volume between baseline and follow-up (day 3-5 for EPITHET; day 6-8 for MR RESCUE)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#3
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730176/thrombectomy-combined-with-indwelling-catheter-thrombolysis-is-more-effective-than-pure-thrombectomy-for-the-treatment-of-lower-extremity-deep-venous-thrombosis
#4
Wenli Wang, Yanfang Wu, Tao Fang, Dunyuan Xu
This study was a retrospective analysis of the efficacy of thrombectomy plus local catheter-directed thrombolysis (CDT) for the treatment of lower extremity deep venous thrombosis (LDVT). The experimental group underwent thrombectomy plus LCDT, whereas the control group underwent thrombectomy plus systemic thrombolysis via the dorsalis pedis vein. Venography and vascular color Doppler ultrasound were performed 7 days after surgery and at follow-up. The differences in the thigh and calf circumferences of normal and affected limbs were compared between groups...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28727354/-endovascular-treatment-for-acute-ischemic-stroke
#5
Zsolt Kulcsar, Emmanuel Carrera, Patrik Michel
The benefit of endovascular treatment (ET) after acute ischemic stroke has long been debated. Recent studies have demonstrated the clinical benefit of ET up to approximately 8 hours after stroke onset, mainly in association with intranenous thrombolysis. The positive effect is higher if ET is initiated early and performed by an experienced team. Current ET techniques include thrombectomy with clot removal using stentretriever technques or local thromboaspiration of the clot. ET seems to be so efficient that stroke care networks have to be organised to offer ET as quickly as possible in all patients who could benefit from this therapy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726653/retrospective-study-of-evaluation-of-patients-with-st-elevation-myocardial-infarction-and-intact-coronary-arteries-evaluation-of-treatment-approaches-outcome-and-prognosis
#6
E Tsetskhladze, I Khintibidze
Myocardial infarction with normal coronary arteries is a well known pathology. It may or may not be associated with left ventricle wall motion abnormalities. Data was reviewed retrospectively for patients with ST elevation myocardial infarction who underwent cardiac catheterization. From the total number of patients evaluated 10.3% (17) patients had Myocardial Infarction with normal coronary arteries. Females were more likely to present with MINCA then males. Coronary flow was normal in 11 from 17 patients with MINCA...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28726048/is-ct-perfusion-helpful-in-the-treatment-allocation-of-patients-with-acute-ischemic-stroke-an-expert-opinion-analysis
#7
Laura Strada, Jonathan Y Streifler, Bruno Del Sette, Matteo Puntoni, Antonio Castaldi, Daria Bianchini, Massimo Del Sette
BACKGROUND: Intravenous tPA is the standard treatment for acute ischemic stroke within 4.5 hours of symptom onset. Neuroradiological selection is currently based upon non-contrast- brain CT scan (NCCT). AIMS: To verify, in an "expert-opinion setting", the possible usefulness of CT perfusion (CTP) in decision-making toward i.v. thrombolysis. PATIENTS AND METHOD: One hundred and three consecutive patients with acute ischemic stroke who underwent NCCT and CTP were re-evaluated by an expert in cerebrovascular disease, to verify if adding CTP information would have changed expert's opinion...
July 19, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#8
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/28724652/correlation-of-admission-heart-rate-with-angiographic-and-clinical-outcomes-in-patients-with-right-coronary-artery-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-horizons-ami-the-harmonizing-outcomes-with-revascularization
#9
Ioanna Kosmidou, Thomas McAndrew, Björn Redfors, Monica Embacher, José M Dizon, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Bradycardia on presentation is frequently observed in patients with right coronary artery ST-segment elevation myocardial infarction, but it is largely unknown whether it predicts poor angiographic or clinical outcomes in that patient population. We sought to determine the prognostic implications of admission heart rate (AHR) in patients with ST-segment elevation myocardial infarction and a right coronary artery culprit lesion. METHODS AND RESULTS: We analyzed 1460 patients with ST-segment elevation myocardial infarction and a right coronary artery culprit lesion enrolled in the randomized HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial who underwent primary percutaneous coronary intervention...
July 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#10
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
https://www.readbyqxmd.com/read/28721323/endovascular-management-of-stroke-patients-with-large-vessel-occlusion-and-minor-stroke-symptoms
#11
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/28720659/microbleeds-cerebral-hemorrhage-and-functional-outcome-after-stroke-thrombolysis-individual-patient-data-meta-analysis
#12
Andreas Charidimou, Guillaume Turc, Catherine Oppenheim, Shenqiang Yan, Jan F Scheitz, Hebun Erdur, Pascal P Klinger-Gratz, Marwan El-Koussy, Wakoh Takahashi, Yusuke Moriya, Duncan Wilson, Chelsea S Kidwell, Jeffrey L Saver, Asma Sallem, Solene Moulin, Myriam Edjlali-Goujon, Vincent Thijs, Zoe Fox, Ashkan Shoamanesh, Gregory W Albers, Heinrich P Mattle, Oscar R Benavente, H Rolf Jäger, Gareth Ambler, Junya Aoki, Jean-Claude Baron, Kazumi Kimura, Wataru Kakuda, Shunya Takizawa, Simon Jung, Christian H Nolte, Min Lou, Charlotte Cordonnier, David J Werring
BACKGROUND AND PURPOSE: We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. METHODS: We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator...
July 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28719398/interventional-approaches-to-deep-venous-thrombosis
#13
Kristen A Lee, Raja S Ramaswamy
PURPOSE OF REVIEW: Catheter-directed therapy in deep vein thrombosis (DVT) is a beneficial adjunct treatment when anticoagulation alone does not provide an adequate therapeutic response. This review aims to deliver an up-to-date discussion behind the rationale, safety profile, and clinical outcomes in endovascular management of DVT. RECENT FINDINGS: Early studies have shown that the use of catheter-directed thrombolysis (CDT) to be successful in rapid thrombus removal, carry a lower incidence of postthrombotic syndrome (PTS), and improved quality of life...
July 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28717986/thrombolysis-for-stroke-in-ireland-increasing-access-and-maintaining-safety-in-a-challenging-environment
#14
P McElwaine, J McCormack, C Brennan, H Coetzee, P Cotter, R Doyle, A Hickey, F Horgan, C Loughnane, C Macey, P Marsden, D McCabe, R Mulcahy, I Noone, E Shelley, T Stapleton, D Williams, P Kelly, J Harbison
BACKGROUND: In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. METHOD: Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study...
July 17, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28717091/thrombolysis-related-multiple-lobar-hemorrhaging-in-cerebral-amyloid-angiopathy-with-extensive-strictly-lobar-cerebral-microbleeding
#15
Makoto Eriguchi, Yusuke Yakushiji, Jun Tanaka, Masashi Nishihara, Hideo Hara
A hemi-paralyzed 86-year-old man was diagnosed with ischemic stroke and underwent thrombolysis. Pre-thrombolysis brain magnetic resonance imaging revealed extensive strictly lobar cerebral microbleeding (CMB). Post-thrombolytic computed tomography revealed asymptomatic multiple intracerebral hemorrhaging (ICH). His age, CMB topography, and decreased cerebral spinal fluid amyloid-β 40 and 42 levels were compatible with a diagnosis of cerebral amyloid angiopathy (CAA). There is no consensus on the safety of thrombolysis for acute stroke patients with CAA...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28716241/low-risk-of-ich-after-reperfusion-therapy-in-acute-stroke-patients-treated-with-direct-oral-anti-coagulant
#16
Kentaro Suzuki, Junya Aoki, Yuki Sakamoto, Arata Abe, Satoshi Suda, Seiji Okubo, Takehiko Nagao, Kazumi Kimura
BACKGROUND: The safety of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in patients treated with DOAC is unclear. We investigated whether recanalization therapy in patients treated with DOAC is safe. METHODS: A nationwide, multicenter, retrospective cohort questionnaire survey was conducted to investigate the: (1) frequency of intracerebral hemorrhage (ICH) after recanalization therapy in patients treated with DOAC; (2) independent factors related to ICH; (3) relationship between last intake time of DOAC and ICH; and (4) comparison of ICH frequency between patients treated with DOAC, vitamin K antagonist (VKA), and no-anticoagulation (no-ACT) (control)...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28714526/different-postconditioning-cycles-affect-prognosis-of-aged-patients-undergoing-primary-percutaneous-coronary-intervention
#17
Jie Zhang, Xin Zhang, Yuqi Cui, Misbahul Ferdous, Lianqun Cui, Peng Zhao
BACKGROUND: Postconditioning can affect the infarct size in acute myocardial infarction (AMI). However, few studies show an effect of different postconditioning cycles on AMI aged patients. This study sought to assess the effect of different postconditioning cycles on prognosis in aged patients with AMI who underwent primary percutaneous coronary intervention (PCI). METHODS: 74 aged patients were randomly assigned to three groups. Control group; PC-1 group accepted postconditioning 4 cycles of 30 s inflation and 30 s deflation; PC-2 group accepted postconditioning 4 cycles of 60 s...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28714314/management-of-myocardial-infarction-in-the-elderly-insights-from-spanish-minimum-basic-data-set
#18
Albert Ariza-Solé, Oriol Alegre, Francisco J Elola, Cristina Fernández, Francesc Formiga, Manuel Martínez-Sellés, José L Bernal, José V Segura, Andrés Iñíguez, Vicente Bertomeu, Joel Salazar-Mendiguchía, José C Sánchez Salado, Victòria Lorente, Angel Cequier
BACKGROUND: We aimed to assess the impact of implementation of reperfusion networks, the type of hospital and specialty of the treating physician on the management and outcomes of ST segment elevation myocardial infarction in patients aged ⩾75 years. METHODS: We analysed data from the Minimum Basic Data Set of the Spanish public health system, assessing hospital discharges between 2004 and 2013. Discharges were distributed in three groups depending on the clinical management: percutaneous coronary intervention, thrombolysis or no reperfusion...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28713330/access-to-thrombolysis-for-non-resident-and-resident-stroke-patients-a-registry-based-comparative-study-from-berlin
#19
Ludwig Schlemm, Guillaume Turc, Heinrich J Audebert, Martin Ebinger
OBJECTIVES: Stroke can happen to people away from home. It is unknown whether non-resident and resident stroke patients have equal access to thrombolysis. MATERIALS AND METHODS: Consecutive patients cared for by the Stroke Emergency Mobile between 2011 and 2016 after prompting suspicion of acute stroke during the emergency call were included in our registry. Patients were categorized as residents or non-residents based on their main address. Clinical characteristics, thrombolysis rates, and time intervals from symptom onset/last seen well to alarm and to thrombolysis were compared between groups adjusting for age, pre-stroke modified Rankin Scale (mRS) score, and National Institutes of Health Stroke Scale (NIHSS) score...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28712001/in-hospital-ischaemic-stroke-treated-with-intravenous-thrombolysis-or-mechanical-thrombectomy
#20
François Caparros, Marc Ferrigno, Amélie Decourcelle, Anais Hochart, Solène Moulin, Nelly Dequatre, Marie Bodenant, Hilde Hénon, Charlotte Cordonnier, Didier Leys
Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition)...
July 15, 2017: Journal of Neurology
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