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https://www.readbyqxmd.com/read/29313057/regional-differences-in-thrombectomy-rates-secondary-use-of-billing-codes-in-the-miracum-medical-informatics-for-research-and-care-in-university-medicine-consortium
#1
Christian Haverkamp, Thomas Ganslandt, Petar Horki, Martin Boeker, Arnd Dörfler, Stefan Schwab, Joachim Berkefeld, Waltraud Pfeilschifter, Wolf-Dirk Niesen, Karl Egger, Manfred Kaps, Marc A Brockmann, Eva Neumaier-Probst, Kristina Szabo, Martin Skalej, Siegfried Bien, Christoph Best, Hans-Ulrich Prokosch, Horst Urbach
BACKGROUND AND PURPOSE: Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine. METHODS: Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines...
January 8, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29304529/passivating-injured-endothelium-with-kinexins-in-thrombolytic-therapy
#2
Yunn-Hwa Ma, Chao-Wei Huang, Chih-Jen Wen, Yi-Ching Lu, Shiaw-Pyng Wey, Tze-Chein Wun
Without conjunctive administration of an anticoagulant, endothelial injury-induced thrombosis is resistant to thrombolysis and prone to re-thrombosis. We hypothesized that co-delivery of recombinant tissue plasminogen activator (rtPA) with annexin V-containing anticoagulants that specifically target the injured endothelium may passivate the thrombogenic elements of the vascular injury site and enhance rtPA-induced thrombolysis. In this study, the effects of conjunctive administration of Kinexins (Kunitz inhibitor-annexin V fusion proteins) with rtPA on thrombolysis were determined in vitro and in vivo...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29304524/amino-fucoidan-as-a-vector-for-rtpa-induced-fibrinolysis-in-experimental-thrombotic-events
#3
Radouane Ghebouli, Stephane Loyau, Murielle Maire, Pierre Saboural, Jean-Philippe Collet, Martine Jandrot-Perrus, Didier Letourneur, Frédéric Chaubet, Jean-Baptiste Michel
Acute ischaemic stroke, myocardial infarction and pulmonary embolism are the main causes of mortality and morbidity worldwide. Thrombolysis by intravenous injection of recombinant tissue plasminogen activator (rtPA) remains the most common non-interventional treatment to recanalize occluded vessels. However, this procedure is limited by significant drawbacks, including high doses and bleeding complications. Recent studies showed that fucoidan targets the intraluminal thrombus in vivo. We have developed a chimaera covalently linking fucoidan, able to target platelets within the thrombus, to dilysine, able to non-covalently bind rtPA...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29273536/variability-of-stroke-patients-meeting-endovascular-stroke-trial-criteria-in-a-non-clinical-trial-setting
#4
Jennifer E Fugate, Waleed Brinjikji, Harry Cloft, David F Kallmes, Alejandro A Rabinstein
BACKGROUND: Five randomized trials proving the efficacy and safety of mechanical embolectomy for ischemic stroke within 8hours used differing radiological methods to select patients. We aimed to evaluate the proportion of patients in clinical practice that would meet radiological criteria for inclusion in these trials. METHODS: Retrospective study of ischemic stroke patients at a large academic medical center who were considered for endovascular stroke therapy based on confirmed intracranial large vessel occlusion from April 2010-November 2014...
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29260035/successful-systemic-thrombolysis-with-rtpa-in-a-patient-with-history-of-a-life-threatening-rtpa-associated-orolingual-angioedema
#5
Johann Otto Pelz, Dominik Michalski, Dorothee Saur
No abstract text is available yet for this article.
September 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29258866/suppression-of-nlrp3-attenuates-hemorrhagic-transformation-after-delayed-rtpa-treatment-in-thromboembolic-stroke-rats-involvement-of-neutrophil-recruitment
#6
Zhiliang Guo, Shuhong Yu, Xin Chen, Ping Zheng, Ting Hu, Zhenhui Duan, Xiaoyun Liu, Qian Liu, Ruidong Ye, Wusheng Zhu, Xinfeng Liu
BACKGROUND: Inflammation and neutrophils play pivotal roles in hemorrhagic transformation (HT) after recombinant tissue plasminogen activator (rtPA) treatment in stroke; however, the contribution of Nod-like receptor protein 3 (NLRP3), a key component of the innate immune system, is not yet known. This study aimed to explore the role of NLRP3 in the delayed rtPA-induced HT and its association with the neutrophil recruitment. METHODS: Rats were subjected to thromboembolic focal cerebral ischemia and delayed rtPA treatment at 4 h after ischemia to mimic HT...
December 16, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/29203753/-definition-and-treatment-of-stroke-over-the-centuries
#7
Anna Starostka-Tatar, Beata Łabuz-Roszak, Michał Skrzypek, Mariusz Gąsior, Marek Gierlotka
Stroke was already diagnosed in the ancient times. For hundreds of years the treatment of this disease has changed radically. According to the current WHO definition, stroke is a clinical syndrome caused by focal or generalized brain injury that lasts more than 24 hours or leads to death and has no other cause than vascular. Stroke constitutes a big social and economic problem, as it can lead to death or disability. In the highly developed countries stroke is the third most common cause of adult deaths, the second leading cause of dementia, and the most common cause of disability...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29198761/diagnostics-treatment-and-secondary-prevention-of-ischemic-stroke-in-the-silesian-province-poland-between-2009-and-2015
#8
Beata Łabuz-Roszak, Anna Starostka-Tatar, Anetta Lasek-Bal, Marek Gierlotka, Mariusz Gąsior, Michał Skrzypek
BACKGROUND: The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated. OBJECTIVE: Therefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population. MATERIALS & METHODS: Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193)...
November 14, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29192346/in-vitro-sonothrombolysis-enhancement-by-transiently-stable-microbubbles-produced-by-a-flow-focusing-microfluidic-device
#9
Adam J Dixon, John Marschner Robert Rickel, Brian D Shin, Alexander L Klibanov, John A Hossack
Therapeutic approaches that enhance thrombolysis by combining recombinant tissue plasminogen activator (rtPA), ultrasound, and/or microbubbles (MBs) are known as sonothrombolysis techniques. To date, sonothrombolysis approaches have primarily utilized commercially available MB formulations (or derivatives thereof) with diameters in the range 1-4 µm and circulation lifetimes between 5 and 15 min. The present study evaluated the in vitro sonothrombolysis efficacy of large diameter MBs (d MB ≥ 10 µm) with much shorter lifetimes that were produced on demand and in close proximity to the blood clot using a flow-focusing microfluidic device...
November 30, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29166463/physicians-are-not-well-informed-about-the-new-guidelines-for-the-treatment-of-acute-stroke
#10
Luana Antunes Maranha Gatto, Gelson Luis Koppe, Zeferino Demartini, Viviane de Hiroki Flumignan Zétola
OBJECTIVE: Treatment of cerebrovascular disease has advanced rapidly in the last two decades. Recent data has added challenges to the treatment of ischemic stroke in the acute phase. OBJECTIVE: To evaluate the knowledge of physicians about the treatment of ischemic stroke in the acute phase. METHODS: An online questionnaire was submitted to all physicians enrolled in the Regional Council of Medicine in Brazil. RESULTS: 456 physicians from different specialties answered the questions...
October 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29153122/age-specific-cost-effectiveness-of-using-intravenous-recombinant-tissue-plasminogen-activator-for-treating-acute-ischemic-stroke
#11
Heesoo Joo, Guijing Wang, Mary G George
INTRODUCTION: Studies have demonstrated that intravenous recombinant tissue plasminogen activator (IV rtPA) is a cost-effective treatment for acute ischemic stroke. Age-specific cost effectiveness has not been well examined. This study estimated age-specific incremental cost-effectiveness ratios (ICERs) of IV rtPA treatment versus no IV rtPA. METHODS: A Markov model was developed to examine the economic impact of IV rtPA over a 20-year time horizon on four age groups (18-44, 45-64, 65-80, and ≥81 years) from the U...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29145482/combination-of-ultrasound-and-rtpa-enhances-fibrinolysis-in-an-in-vitro-clot-system
#12
Julia Masomi-Bornwasser, Philipp Winter, Hendrik Müller-Werkmeister, Susanne Strand, Jochem König, Oliver Kempski, Florian Ringel, Sven R Kantelhardt, Naureen Keric
BACKGROUND: Catheter-based lysis with recombinant tissue plasminogen activator (rtPA) is a well-established therapy for spontaneous intracerebral hemorrhage (ICH). The effectiveness of this therapy can be increased with ultrasound, but the optimal conditions are not yet clearly established. Using a novel in vitro system of blood clots previously developed by our group, we investigated various parameters of intralesional sonothrombolysis using an endosonography catheter in combination with rtPA...
2017: PloS One
https://www.readbyqxmd.com/read/29137061/low-free-triiodothyronine-levels-predict-symptomatic-intracranial-hemorrhage-and-worse-short-term-outcome-of-thrombolysis-in-patients-with-acute-ischemia-stroke
#13
Mingjing Qiu, Min Fang, Xueyuan Liu
The aim of the study was to determine whether thyroid hormones level on admission in patients with ischemic stroke, treated with intravenous recombinant tissue type plasminogen activator (rtPA), was associated with symptomatic intracranial hemorrhage (sICH) and worse outcomes at 3 months.Patients with acute ischemic stroke (AIS) receiving intravenous rtPA thrombolytic treatment on our stroke unit between January 2015 and June 2016 were included in this study. Serum-free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (tT3), total thyroxine (tT4), and thyroid-stimulating hormone (TSH) were detected on admission...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#14
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29116545/intravenous-thrombolysis-in-sle-related-stroke-a-case-report-and-literature-review
#15
Xiaodong Chen, Gelin Xu
Patients with systemic lupus erythematosus (SLE) bear an increased risk of ischemic stroke. However, evidences for treating acute stroke due to artery thrombosis in SLE patients are extremely limited. A 45-year-old woman experienced sudden left hemiplegia. She was transported to the emergency department of our hospital 2 hours after the initial symptom. According to the medical records, the patient was diagnosed with SLE at the age of 28. CT scanned 150 min after the initial symptom showed no evidence of acute changes or hemorrhage...
November 7, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29102234/acute-treatment-of-stroke-due-to-spontaneous-calcified-cerebral-emboli-causing-large-vessel-occlusion
#16
REVIEW
Muhammad Faraz Raghib, Johannes Sebastian Mutzenbach, Cornelia Rösler, Ferdinand Otto, Mark Mc Coy, Erasmia Müller-Thies-Broussalis, Slaven Pikija
INTRODUCTION: Calcified cerebral emboli (CCE) are rarely responsible for large vessel occlusion (LVO) in acute anterior stroke, and therefore therapeutic experience is scarce. We sought to expand current knowledge upon therapeutic options with three new cases and a review of current literature. METHODS: Systematic search of patients with acute anterior stroke due to LVO in one comprehensive stroke center throughout a 4 year period. Literature search for reported cases of CCE...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29100857/safe-readministration-of-intravenous-thrombolysis-in-recurrent-basilar-thrombosis
#17
Alina Khan, Ahmed Itrat
We report a patient who had recurrence of stroke in the basilar artery territory because of repeat thrombosis, and was administered intravenous recombinant tissue plasminogen activator (IV-rtPA) twice within a span of 3 weeks without any adverse events, with radiological evidence of successful thrombolysis. Because of minor and improving stroke symptoms with IV-rtPA, endovascular therapy was not performed and there was radiological evidence of recanalization with IV-rtPA alone. This report adds to the very limited literature on the topic demonstrating safe and successful use of repeat IV thrombolysis following a previous recent stroke...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29027122/hi1a-as-a-novel-neuroprotective-agent-for-ischemic-stroke-by-inhibition-of-acid-sensing-ion-channel-1a
#18
Yandong Ren, Chengchong Li, Jinlong Chang, Rui Wang, Yuhua Wang, Xiang-Ping Chu
Strokes are the second-leading cause of death worldwide, and the cellular and molecular mechanisms underlying stroke-induced brain damage are still uncertain. The present therapy for acute ischemic stroke is limited to thrombolysis with the recombinant tissue plasminogen activator (rtPA). However, rtPA has a narrow therapeutic timeframe of 3-4.5 h, and only approximately 5% of stroke patients can benefit from rtPA treatment. Neuroprotective agents, such as N-methyl-D-aspartate receptor antagonists, have shown great promise in preclinical studies...
October 13, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28988732/rupture-of-an-occult-intracranial-mycotic-aneurysm-after-intravenous-thrombolysis-with-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#19
Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A James, C Keith Stone
BACKGROUND: The treatment of acute ischemic stroke with recombinant tissue plasminogen activator (rtPA) has become the mainstay of treatment, but its use carries a risk of subsequent intracranial hemorrhage (ICH). Guidelines have been developed to aid in the selection of the appropriate candidates to treat with rtPA to reduce this risk. We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA)...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987516/cannabis-can-augment-thrombolytic-properties-of-rtpa-case-report-of-an-intracranial-hemorrhage-in-a-heavy-cannabis-user
#20
Amar Shere, Hemant Goyal
Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke...
September 28, 2017: American Journal of Emergency Medicine
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