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Intravenous tissue plasminogen activator

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https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#1
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28341074/long-term-prognosis-in-ischemic-stroke-patients-treated-with-intravenous-thrombolytic-therapy
#2
Maja Stefanovic Budimkic, Tatjana Pekmezovic, Ljiljana Beslac-Bumbasirevic, Marko Ercegovac, Ivana Berisavac, Predrag Stanarcevic, Visnja Padjen, Dejana R Jovanović
BACKGROUND AND PURPOSE: It remains unclear if intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator has an impact on the survival and maintenance of a favorable effect on functional recovery over a long follow-up period. The aim of this study was to assess whether or not IVT treatment has a favorable effect on functional recovery and survival less than 1 year after a stroke. METHODS: This matched cohort study included 259 patients with acute ischemic stroke (IS) who were treated with IVT and standard care and 259 patients treated with standard care alone in the stroke unit between February 2006 and January 2013...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#3
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28298840/the-need-for-a-population-based-dose-optimization-study-for-recombinant-tissue-plasminogen-activator-in-acute-ischemic-stroke-a-study-from-a-tertiary-care-teaching-hospital-from-south-india
#4
Siju V Abraham, Fazil Thaha, S Vimal Krishnan, Athulya Shajan, Jayaraj Mymbilly Balakrishnan, Babu Urumese Palatty
CONTEXT: The guideline recommended dose of intravenous (i.v) recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke is 0.9 mg/kg in the European and American populations. In Asiatic population, some studies have shown that a lower dose of i.v rt-PA is equally efficacious. AIMS: To assess if there is a need for a dose optimization for i.v rt-PA study among Indians. SETTING AND DESIGN: A prospective, observational database of acute stroke cases that presented to a tertiary care institute over a period of 1 year was made...
January 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28298139/emergent-carotid-stenting-and-intra-arterial-abciximab-in-acute-ischemic-stroke-due-to-tandem-occlusion
#5
Fawaz Al-Mufti, Krishna Amuluru, Nathan W Manning, Imad Khan, Lissa Peeling, Chirag D Gandhi, Charles J Prestigiacomo, Galyna Pushchinska, David Fiorella, Henry H Woo
OBJECTIVE: Acute occlusions of the extracranial internal carotid artery (ICA) and a major intracranial artery respond poorly to intravenous tissue plasminogen activator (tPA) and present an endovascular challenge. The aim of our study was to retrospectively delineate the feasibility of the combined use of emergent carotid stenting and intra-arterial (IA) Abciximab with intracranial revascularization in the setting of acute ischemic stroke and carotid occlusions at our institution. METHODS: Eleven patients with complete cervical carotid occlusion with or without concomitant intracranial ICA and/or MCA occlusion were identified from a single center, retrospective review of patients admitted to the Stroke unit...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28296671/the-use-of-thrombolytic-therapy-in-the-treatment-of-frostbite-injury
#6
Allyson Wexler, Sarah Zavala
Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. A retrospective chart review was performed on all patients admitted for frostbite between January 2008 and April 2015, and six patients were identified as having received treatment with intravenous tPA. Patients received an initial bolus dose followed by a 6-hour infusion of tPA...
March 3, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28292637/patterns-and-predictors-of-peripherally-inserted-central-catheter-occlusion-the-3p-o-study
#7
Shawna N Smith, Nancy Moureau, Valerie M Vaughn, Tanya Boldenow, Scott Kaatz, Paul J Grant, Steven J Bernstein, Scott A Flanders, Vineet Chopra
PURPOSE: To evaluate patterns and predictors of peripherally inserted central catheter (PICC)-related occlusion. MATERIALS AND METHODS: Data from a multihospital study were used to examine factors associated with PICC occlusion. Occlusion was defined if documented in the medical record or when tissue plasminogen activator was administered for occlusion-related concerns. Mixed-effects logistic regression was used to predict occlusion, controlling for patient-, provider-, device-, and hospital-level characteristics...
March 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28283606/predictive-value-of-rapid-assessed-perfusion-thresholds-on-final-infarct-volume-in-swift-prime-solitaire-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment
#8
Maxim Mokin, Elad I Levy, Jeffrey L Saver, Adnan H Siddiqui, Mayank Goyal, Alain Bonafé, Christophe Cognard, Reza Jahan, Gregory W Albers
BACKGROUND AND PURPOSE: Computed tomography perfusion imaging can estimate the size of the ischemic core, which can be used for the selection of patients for endovascular therapy. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) thresholds chosen to identify ischemic core influence the accuracy of prediction. We aimed to analyze the accuracy of various rCBV and rCBF thresholds for predicting the 27-hour infarct volume using RAPID automated analysis software from the SWIFT PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment) data...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28277463/intravenous-and-arterial-treatments-for-acute-ischemic-stroke-indications-and-the-role-of-imaging
#9
Haris Kamal, Sunil A Sheth
Acute ischemic stroke continues to be a leading cause of disability in adults and the fifth leading cause of mortality worldwide. In the past few years, acute ischemic stroke diagnosis and management has advanced by leaps and bounds, with the lengthening of the time window for intravenous tissue plasminogen activator and the establishment of endovascular stroke therapy. As a result of these changes, the focus today has shifted from proving efficacy to expanding indications and identifying all patients who may benefit from these therapies...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28276591/postprocedure-subarachnoid-hemorrhage-after-endovascular-treatment-for-acute-ischemic-stroke
#10
Adnan I Qureshi, Muhammad A Saleem, Emrah Aytac
BACKGROUND: The rate of occurrence and associated outcomes of subarachnoid hemorrhage (SAH) in acute ischemic stroke patients following endovascular treatment is not well studied. METHODS: We analyzed data from subjects treated with intravenous recombinant tissue plasminogen activator followed by endovascular treatment in the Interventional Management of Stroke III trial. The baseline and 24 (±6) hours postrandomization computed tomographic scans were interpreted centrally for presence, type, and location of intracranial hemorrhages (ICHs) including SAH...
March 9, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28275651/platelet-microparticles-a-biomarker-for-recanalization-in-rtpa-treated-ischemic-stroke-patients
#11
Andrew Bivard, Lisa F Lincz, Jane Maquire, Mark Parsons, Christopher Levi
OBJECTIVES: Identification of a biomarker for acute recanalization could have significant clinical impact. METHODS: We prospectively collected baseline, 24-h, and 90-day clinical and imaging data from consecutive ischemic stroke patients who fulfilled standard clinical eligibility criteria for treatment with intravenous recombinant tissue plasminogen activator (rtPA). Computed tomography angiography was acquired at 24 h and assessed using the thrombolysis is myocardial infarction (TIMI) scale with a score of 2b/3 indicating recanalization...
March 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28266892/inflammatory-and-metalloproteinases-profiles-predict-three-month-poor-outcomes-in-ischemic-stroke-treated-with-thrombolysis
#12
Anna Maria Gori, Betti Giusti, Benedetta Piccardi, Patrizia Nencini, Vanessa Palumbo, Mascia Nesi, Antonia Nucera, Giovanni Pracucci, Paolina Tonelli, Eleonora Innocenti, Alice Sereni, Elena Sticchi, Danilo Toni, Paolo Bovi, Mario Guidotti, Maria Rosaria Tola, Domenico Consoli, Giuseppe Micieli, Rossana Tassi, Giovanni Orlandi, Maria Sessa, Francesco Perini, Maria Luisa Delodovici, Maria Luisa Zedde, Francesca Massaro, Rosanna Abbate, Domenico Inzitari
Inflammatory mediators and metalloproteinases are altered in acute ischemic stroke (AIS) and play a detrimental effect on clinical severity and hemorrhagic transformation of the ischemic brain lesion. Using data from the Italian multicenter observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) Study, we evaluated the effect of inflammatory and metalloproteinases profiles on three-month functional outcome, hemorrhagic transformation and mortality in 327 patients with AIS treated with intravenous thrombolys in according to SITS-MOST (Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy) criteria...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28259886/post-stroke-seizures-is-associated-with-low-alberta-stroke-program-early-ct-score
#13
Ziyuan Chen, Leonid Churilov, Miriam Koome, Ziyi Chen, Jillian Naylor, Patrick Kwan, Bernard Yan
BACKGROUND: Ischemic stroke is a leading cause of new-onset seizures. Cortical ischemia and large ischemic lesion size are among the most consistently reported risk factors for post-stroke seizures. Alberta Stroke Program Early CT Score (ASPECTS) is a simple and reliable tool for quantifying the extent of cerebral ischemia and may function as a screening tool for patients with high risk of seizure development. We investigated the association of post-stroke seizures with the extent of ischemia assessed by ASPECTS and with cortical involvement identified on non-contrast CT (NCCT)...
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28243834/sodium-tanshinone-iia-sulfonate-enhances-effectiveness-rt-pa-treatment-in-acute-ischemic-stroke-patients-associated-with-ameliorating-blood-brain-barrier-damage
#14
Biying Ji, Fei Zhou, Lijuan Han, Jun Yang, Haijian Fan, Shanshan Li, Jingwei Li, Xin Zhang, Xiaoying Wang, Xiangyan Chen, Yun Xu
Treatment with sodium tanshinone IIA sulfonate (STS) may ameliorate blood-brain barrier (BBB) damage in acute ischemic stroke patients receiving recombinant tissue plasminogen activator (rt-PA) thrombolysis and improve stroke patients' outcome. This randomized, single-center, placebo-controlled clinical trial investigated the potential effects and underlying mechanisms of STS. Forty-two acute ischemic stroke patients receiving intravenous rt-PA thrombolysis were randomized to intravenous administration either with STS (60 mg/day) (n = 21) or with equivalent volume of saline as a placebo (n = 21) after randomization for 10 days...
February 27, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28237123/temporal-trends-in-intravenous-thrombolysis-in-acute-ischemic-stroke-experience-from-a-tertiary-care-center-in-india
#15
Dheeraj Khurana, Biplab Das, Ashok Kumar, Amith Kumar S, Niranjan Khandelwal, Vivek Lal, Sudesh Prabhakar
BACKGROUND: Acute ischemic stroke (AIS) is a time-dependent treatable cause of morbidity and mortality. Despite the increasing stroke incidence in developing countries, parallel increasing stroke thrombolysis rates have not been documented. AIM: This study aims to determine trends in patient characteristics and rates of recombinant tissue plasminogen activator (rtPA) use in AIS patients in a tertiary care center in northern India. METHODS: All AIS patients presenting within 8 hours of symptoms onset from January 2011 to December 2015 were enrolled and analyzed...
February 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28228574/delays-in-door-to-needle-times-and-their-impact-on-treatment-time-and-outcomes-in-get-with-the-guidelines-stroke
#16
Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D Hill, Deepak L Bhatt, Jeffrey L Saver, Mathew J Reeves, Gregg C Fonarow, Lee H Schwamm, Eric E Smith
BACKGROUND AND PURPOSE: Despite quality improvement programs such as the American Heart Association/American Stroke Association Target Stroke initiative, a substantial portion of acute ischemic stroke patients are still treated with tissue-type plasminogen activator (alteplase) later than 60 minutes from arrival. This study aims to describe the documented reasons for delays and the associations between reasons for delays and patient outcomes. METHODS: We analyzed the characteristics of 55 296 patients who received intravenous alteplase in 1422 hospitals participating in Get With The Guidelines-Stroke from October 2012 to April 2015, excluding transferred patients and inpatient strokes...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228323/evaluation-of-the-role-of-susceptibility-weighted-imaging-in-thrombolytic-therapy-for-acute-ischemic-stroke
#17
Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang
We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA)...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28222621/digestive-and-urologic-hemorrhage-after-intravenous-thrombolysis-for-acute-ischemic-stroke-data-from-a-chinese-stroke-center
#18
Hong Chang, Xiaojuan Wang, Xin Yang, Haiqing Song, Yuchen Qiao, Jia Liu
Objective Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) is considered the most effective treatment method for AIS; however, it is associated with a risk of hemorrhage. We analyzed the risk factors for digestive and urologic hemorrhage during rt-PA therapy. Methods We retrospectively analyzed patients with AIS who underwent intravenous thrombolysis with rt-PA during a 5-year period in a Chinese stroke center. Data on the demographics, medical history, laboratory test results, and clinical outcomes were collected...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28222238/thrombolysis-with-intravenous-recombinant-tissue-plasminogen-activator-during-early-postpartum-period-a-review-of-the-literature
#19
Munetoshi Akazawa, Makoto Nishida
Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28211169/a-first-in-human-study-of-ds-1040-an-inhibitor-of-the-activated-form-of-thrombin-activatable-fibrinolysis-inhibitor-in-healthy-subjects
#20
J Zhou, J Kochan, O Yin, V Warren, C Zamora, G Atiee, J Pav, Y Orihashi, V Vashi, V Dishy
Essentials DS-1040 inhibits the activated form of thrombin-activatable fibrinolysis inhibitor (TAFIa). Infusion of DS-1040 was safe and well tolerated in healthy young and elderly subjects. DS-1040 substantially decreased TAFIa activity but had no impact on bleeding time. DS-1040 may provide an option of safer thrombolytic therapy. SUMMARY: Background Current treatments for acute ischemic stroke and venous thromboembolism, such as recombinant tissue-type plasminogen activator and thrombectomy, are limited by a narrow time window and the risk of bleeding...
February 17, 2017: Journal of Thrombosis and Haemostasis: JTH
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