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Intravenous tissue plasminogen activator

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https://www.readbyqxmd.com/read/29769590/low-factor-xiii-levels-after-intravenous-thrombolysis-predict-short-term-mortality-in-ischemic-stroke-patients
#1
Edina Gabriella Székely, Katalin Réka Czuriga-Kovács, Zsuzsanna Bereczky, Éva Katona, Zoltán András Mezei, Attila Nagy, Noémi Klára Tóth, Ervin Berényi, László Muszbek, László Csiba, Zsuzsa Bagoly
In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29765396/acute-in-stent-thrombosis-after-carotid-angioplasty-and-stenting-a-case-report-and-literature-review
#2
Wei Hu, Li Wang, GuoPing Wang
Background: Based on the results of a recent randomized controlled trial, carotid artery stenting (CAS) was regarded as a relatively safe, less invasive treatment of internal carotid artery stenosis. However, cerebral thromboembolic events are the most common complications of CAS. Especially acute stent thrombosis following CAS will be fatal without prompt diagnosis and revascularization. Case Report: We report a case of acute stent thrombosis in whom carotid revascularization was performed successfully via arterial thrombolysis and balloon postdilation...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764930/closure-of-large-bore-9-f-arterial-puncture-sites-with-the-angioseal-sts-device-in-acute-stroke-patients-after-intravenous-recombinant-tissue-plasminogen-activator-rt-pa
#3
Hendrik Janssen, Monika Killer-Oberpfalzer, Ruediger Lange
PURPOSE: This retrospective analysis was performed to evaluate whether large bore 9 F puncture sites can be safely closed with the 8 F AngioSeal STS device after endovascular stroke procedures in patients who did or did not receive recombinant tissue plasminogen activator (rt-PA). METHODS: Out of 161 consecutive endovascular stroke procedures we identified 72 patients who met the inclusion criteria, of whom 46 received rt-PA before the endovascular procedure and 26 did not...
May 15, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29761023/comparing-outcome-and-recanalization-results-in-patients-with-anterior-circulation-stroke-following-endovascular-treatment-with-and-without-a-treatment-with-rt-pa-a-single-center-study
#4
Mohamed Al-Khaled, Toralf Brüning, Carina Gottwald, Florian Roessler, Georg Royl, Thomas Eckey
Objectives: Endovascular treatment (ET), in addition to a therapy with intravenous recombinant tissue plasminogen activator IV rt-PA in patients with acute ischemic stroke, has been found to improve outcome. However, data about ET in patients who have not received therapy with rt-PA due to contraindications for IV rt-PA are sparse. Comparison of ET with IV rt-PA versus ET alone in patients with stroke is done using a proximal intracranial arterial occlusion (internal carotid artery, middle cerebral artery (M1-Segment))...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29758126/abrogating-fibrinolysis-does-not-improve-bleeding-or-rfviia-rfviii-treatment-in-a-non-mucosal-venous-injury-model-in-haemophilic-rodents
#5
Rikke Stagaard, Matthew J Flick, Barbara Bojko, Krzysztof Goryński, Paulina Z Goryńska, Carsten D Ley, Lisbeth H Olsen, Tom Knudsen
BACKGROUND: Fibrinolysis may exacerbate bleeding in haemophilia A (HA). Accordingly, antifibrinolytics have been used to help maintain haemostatic control. While antifibrinolytic drugs have been proven effective in the treatment of mucosal bleeds in the oral cavity, their efficacy in non-mucosal tissues remain an open question of significant clinical interest. OBJECTIVE: To determine whether inhibiting fibrinolysis improves the outcome in non-mucosal haemophilic tail vein transection (TVT) bleeding models, and to determine whether a standard ex vivo clotting/fibrinolysis assay can be used as a predictive surrogate for in vivo efficacy...
May 14, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#6
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29752869/allogeneic-umbilical-cord-blood-infusion-for-adults-with-ischemic-stroke-clinical-outcomes-from-a-phase-1-safety-study
#7
Daniel T Laskowitz, Ellen R Bennett, Rebecca J Durham, John J Volpi, Jonathan R Wiese, Michael Frankel, Elizabeth Shpall, Jeffry M Wilson, Jesse Troy, Joanne Kurtzberg
Stroke is a major cause of death and long-term disability, affecting one in six people worldwide. The only currently available approved pharmacological treatment for ischemic stroke is tissue plasminogen activator; however, relatively few patients are eligible for this therapy. We hypothesized that intravenous (IV) infusion of banked unrelated allogeneic umbilical cord blood (UCB) would improve functional outcomes in patients with ischemic stroke. To investigate this, we conducted a phase 1 open-label trial to assess the safety and feasibility of a single IV infusion of non-human leukocyte antigen (HLA) matched, ABO matched, unrelated allogeneic UCB into adult stroke patients...
May 12, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29748424/intravenous-recombinant-tissue-type-plasminogen-activator-influence-on-outcome-in-anterior-circulation-ischemic-stroke-treated-by-mechanical-thrombectomy
#8
Marc Ferrigno, Nicolas Bricout, Didier Leys, Laurent Estrade, Charlotte Cordonnier, Thomas Personnic, Maeva Kyheng, Hilde Henon
BACKGROUND AND PURPOSE: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) improves functional outcome in patients with ischemic stroke related to proximal-vessel occlusion in the anterior circulation. Whether MT alone is as effective as IVT/MT remains controversial. We aimed at evaluating the influence of IVT in patients with large anterior circulation artery occlusion treated with MT. METHODS: We did a prospective observational cohort study in patients with stroke related to large anterior circulation artery occlusion treated by MT who were admitted to Lille University Hospital, Lille, France...
May 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29728903/tenecteplase-versus-alteplase-in-acute-ischemic-stroke-systematic-review-and-meta-analysis
#9
A Thelengana, Divya M Radhakrishnan, Manya Prasad, Amit Kumar, Kameshwar Prasad
Tenecteplase is a product of genetic modification of recombinant tissue plasminogen activator with superior pharmacodynamic and pharmacokinetic properties. This meta-analysis was to determine whether intravenous thrombolysis with tenecteplase in patients with acute ischemic stroke has better efficacy and safety outcomes than with intravenous alteplase. PubMed, Cochrane Central Register of Controlled Trials, WHO International clinical trials registry platform (ICTRP), Australian New Zealand Clinical Trials Registry (ANZCTR), EU Clinical Trials Register (EU-CTR) and ClinicalTrials...
May 4, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29725176/clinical-outcomes-of-endovascular-thrombectomy-in-tissue-plasminogen-activator-versus-non-tissue-plasminogen-activator-patients-at-primary-stroke-care-centers
#10
Gregory Imbarrato, Joshua Bentley, Ajeet Gordhan
Background: The effect of intravenous tissue plasminogen activator (IV tPA) administration before endovascular intervention as compared to without at thrombectomy-capable low-volume centers on procedural aspects and patient outcomes has not been investigated. Methods: Retrospective chart review was performed in all consecutive large vessel cerebrovascular accident patients treated with endovascular therapy at two select rural primary stroke centers between 2011 and 2015...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29721400/a-direct-aspiration-first-pass-technique-for-mechanical-thrombectomy-in-the-setting-of-a-suspected-cerebral-aneurysm
#11
Ali S Haider, Suraj Sulhan, Dean Leonard, Haris Rana, Umair Khan, Tijani Osumah, Steven Vayalumkal, Richa Thakur, Kennith F Layton
There is little guidance in the literature on which thrombectomy technique is preferred in patients with acute ischemic stroke and concomitant aneurysms. Here, we present the case of a 58-year-old female with an acute ischemic stroke requiring emergent thrombectomy that was complicated by the presence of multiple, nonruptured intracranial aneurysms. Imaging confirmed an occlusion of the right middle cerebral artery and multiple nonruptured intracranial aneurysms. The patient was administered intravenous recombinant tissue plasminogen activator and the thrombus was aspirated via a direct aspiration first pass technique (ADAPT)...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29720439/time-to-decision-and-treatment-with-tpa-tissue-type-plasminogen-activator-using-telemedicine-versus-an-onboard-neurologist-on-a-mobile-stroke-unit
#12
Ritvij Bowry, Stephanie A Parker, Jose-Miguel Yamal, Hyunsoo Hwang, Savitri Appana, Nicole Rangel-Gutierrez, Tzu-Ching Wu, Suja S Rajan, James C Grotta
BACKGROUND AND PURPOSE: Mobile stroke units (MSUs) can speed treatment with intravenous tPA (tissue-type plasminogen activator). We previously showed substantial agreement between a telemedicine-based vascular neurologist (TM-VN) and an onboard vascular neurologist (OB-VN) for the evaluation of patients with stroke for tPA eligibility on an MSU. However, the time efficiency of the telemedicine-based evaluation remained uncertain. In this study, we examined the speed of decision and treatment from MSU arrival for the TM-VN compared with an OB-VN...
May 2, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29720437/prediction-of-tissue-outcome-and-assessment-of-treatment-effect-in-acute-ischemic-stroke-using-deep-learning
#13
Anne Nielsen, Mikkel Bo Hansen, Anna Tietze, Kim Mouridsen
BACKGROUND AND PURPOSE: Treatment options for patients with acute ischemic stroke depend on the volume of salvageable tissue. This volume assessment is currently based on fixed thresholds and single imagine modalities, limiting accuracy. We wish to develop and validate a predictive model capable of automatically identifying and combining acute imaging features to accurately predict final lesion volume. METHODS: Using acute magnetic resonance imaging, we developed and trained a deep convolutional neural network (CNNdeep ) to predict final imaging outcome...
May 2, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29718846/high-risk-pulmonary-embolism-assessed-by-transthoracic-echocardiography-a-case-report
#14
Jiahong Wu, Jing Zhang, Fangfang Yang, Chuanbao Li, Mei Ni
RATIONALE: Acute pulmonary embolism (APE) as a life-threatening illness may present with a wide range of manifestations. APE was diagnosed using computed tomographic pulmonary angiography (CTPA); however, transthoracic echocardiography (TTE) can reveal hemodynamic status. Early thrombolysis is the most effective therapy for the treatment of massive pulmonary embolism. PATIENTS CONCERNS: Herein, we report a case of high-risk APE with a wide range of manifestations, including chest pain, dyspnea, low-blood pressure, and syncope...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29715283/leukoaraiosis-and-risk-of-intracranial-hemorrhage-and-outcome-after-stroke-thrombolysis
#15
Chun-Ming Yang, Chien-Ling Hung, Hui-Chen Su, Huey-Juan Lin, Chih-Hung Chen, Chou-Ching Lin, Han-Hwa Hu, Sheng-Hsiang Lin, Pi-Shan Sung
BACKGROUND: The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. METHODS: Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29712881/delays-in-the-air-or-ground-transfer-of-patients-for-endovascular-thrombectomy
#16
Robert W Regenhardt, Adam P Mecca, Stephanie A Flavin, Gregoire Boulouis, Arne Lauer, Kori Sauser Zachrison, James Boomhower, Aman B Patel, Joshua A Hirsch, Lee H Schwamm, Thabele M Leslie-Mazwi
BACKGROUND AND PURPOSE: For suspected large vessel occlusion patients efficient transfer to centers that provide endovascular therapy (ET) is critical to maximizing treatment opportunity. Our objective was to examine associations between transfer time, modes of transfer, ET, and outcomes within a hub-and-spoke telestroke network. METHODS: Patients with ischemic stroke were included if transferred to a single hub hospital between January 2011 and October 2015 with National Institutes of Health Stroke Scale>6, onset<12 hours from hub arrival with complete clinical, imaging, and transfer data...
April 30, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29686025/shorter-intensive-care-unit-stays-the-majority-of-post-intravenous-tpa-tissue-type-plasminogen-activator-symptomatic-hemorrhages-occur-within-12-hours-of-treatment
#17
Adam Chang, Edward J Llinas, Karen Chen, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND AND PURPOSE: Symptomatic intracranial hemorrhage (sICH) is a life-threatening complication after treatment with intravenous tPA (tissue-type plasminogen activator) for acute stroke. Currently, patients are monitored for sICH in a neurocritical care unit or intensive care unit-like setting for 24 hours post-treatment-a costly and resource intensive practice. Because the half-life of tPA is much shorter than 24 hours, it is possible that the majority of patients do not require such intensive monitoring...
April 23, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29683506/noncoding-rnas-in-ischemic-stroke-time-to-translate
#18
REVIEW
Harpreet Kaur, Deepaneeta Sarmah, Jackson Saraf, Kanchan Vats, Kiran Kalia, Anupom Borah, Dileep R Yavagal, Kunjan R Dave, Zhumur Ghosh, Pallab Bhattacharya
Stroke is devastating and a major cause of morbidity and mortality around globe. Current interventions for ischemic stroke include thrombolytics, clot retrieval devices and/or intravenous tissue plasminogen activators (tPA), the latter two becoming the first line of treatment. Owing to the limitations of tPA to elicit therapeutic benefits in a narrow time window, new pharmacological interventions are needed. Exploring noncoding RNAs (ncRNAs) may be a promising option for stroke treatment. ncRNAs are endogenous molecules that play key roles in the pathophysiology of many functions and diseases, including during ischemic stroke...
April 23, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29673293/systemic-thrombolytic-therapy-for-massive-and-submassive-pulmonary-embolism
#19
Lauren A Igneri, John M Hammer
OBJECTIVE: To critically evaluate the published literature assessing the safety and efficacy of thrombolytic therapy for massive and submassive pulmonary embolism (PE). METHODS: A search of human trials in the English-language (September 2017) was conducted through the MEDLINE database using the following terms: PE, tissue plasminogen activator, tenecteplase, and alteplase. 67 unique articles were identified, of which 24 clinical trials discussing clinical outcomes related to administration of either intravenous tenecteplase or alteplase were included...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29669118/addressing-the-role-of-intravenous-tissue-plasminogen-activator-in-patients-with-large-vessel-occlusions
#20
Benjamin Zussman, Gregory Weiner, Andrew Ducruet
No abstract text is available yet for this article.
May 1, 2018: Neurosurgery
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