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https://www.readbyqxmd.com/read/28737109/clinical-outcome-prediction-after-thrombectomy-of-proximal-middle-cerebral-artery-occlusions-by-the-appearance-of-lenticulostriate-arteries-on-magnetic-resonance-angiography-a-retrospective-analysis
#1
Johannes Kaesmacher, Kornelia Kreiser, Nathan W Manning, Alexandra S Gersing, Silke Wunderlich, Claus Zimmer, Justus F Kleine, Benedikt Wiestler, Tobias Boeckh-Behrens
Post-ischemic vasodynamic changes in infarcted brain parenchyma are common and range from hypo- to hyperperfusion. In the present study, appearance of the lenticulostriate arteries (LSAs) on postinterventional 3T time-of-flight (TOF)-MRA suggestive for altered post-stroke vasodynamics following thrombectomy was investigated. Patients who underwent thrombectomy for a proximal MCA occlusion and for whom postinterventional 3T TOF-MRA (median at day 3) was available, were included in this retrospective analysis (n=98)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28736623/a-literature-review-of-cost-effectiveness-of-intravenous-recombinant-tissue-plasminogen-activator-for-treating-acute-ischemic-stroke
#2
Heesoo Joo, Guijing Wang, Mary G George
BACKGROUND: Intravenous recombinant tissue plasminogen activator (IV rtPA) is recommended treatment for acute ischemic stroke patients, but the cost-effectiveness of IV rtPA within different time windows after the onset of acute ischemic stroke is not well reviewed. AIMS: To conduct a literature review of the cost-effectiveness studies about IV rtPA by treatment times. SUMMARY OF REVIEW: A literature search was conducted using MEDLINE, EMBASE, CINAHL and Cochrane Library, with the key words acute ischemic stroke, tissue plasminogen activator, cost, economic benefit, saving, and incremental cost-effectiveness analysis...
2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28685662/simultaneous-functional-photoacoustic-microscopy-and-electrocorticography-reveal-the-impact-of-rtpa-on-dynamic-neurovascular-functions-after-cerebral-ischemia
#3
Aishwarya Bandla, Lun-De Liao, Su Jing Chan, Ji Min Ling, Yu-Hang Liu, Yen-Yu Ian Shih, Han-Chi Pan, Peter Tsun-Hon Wong, Hsin-Yi Lai, Nicolas Kon Kam King, You-Yin Chen, Wai Hoe Ng, Nitish V Thakor
The advance of thrombolytic therapy has been hampered by the lack of optimization of the therapy during the hyperacute phase of focal ischemia. Here, we investigate neurovascular dynamics using a custom-designed hybrid electrocorticography (ECoG)-functional photoacoustic microscopy (fPAM) imaging system during the hyperacute phase (first 6 h) of photothrombotic ischemia (PTI) in male Wistar rats following recombinant tissue plasminogen activator (rtPA)-mediated thrombolysis. We reported, for the first time, the changes in neural activity and cerebral hemodynamic responses following rtPA infusion at different time points post PTI...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28650062/safety-and-outcome-of-rtpa-in-acute-ischemic-stroke-in-patients-with-active-cancer-case-control-study
#4
T Geraldes, L Pereira, C Guarda, M Grunho, A C Ribeiro, J Coimbra, I Mendes, M Rodrigues
INTRODUCTION: Cancer patients have increased stroke risk from direct and indirect malignancy effects. Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is standard medical treatment for acute ischemic stroke (AIS). AIM: To review rtPA use in AIS patients with active cancer. SUBJECTS AND METHODS: Retrospective observational case-control study evaluating patients with AIS and cancer admitted to our stroke unit between January/2010 and June/2015...
July 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28611829/stent-retriever-mediated-manual-aspiration-thrombectomy-for-acute-ischemic-stroke
#5
Ashutosh P Jadhav, Amin Aghaebrahim, Anat Horev, Dan-Victor Giurgiutiu, Andrew F Ducruet, Brian Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: Stent retriever thrombectomy and manual aspiration thrombectomy (MAT) have each been shown to lead to high rates of recanalization as single-modality endovascular stroke therapy. We sought to describe the safety and efficacy of a multimodal approach combining these two techniques termed 'stent retriever-mediated manual aspiration thrombectomy' (SMAT) and compared them to MAT alone. METHODS: Retrospective review of a prospectively acquired acute endovascular stroke database...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28592784/nationwide-hospital-emergent-capability-accreditation-by-level-stroke-improves-stroke-treatment-in-taiwan
#6
Tain-Junn Cheng, Giia-Sheun Peng, Wei-Siang Jhao, Jiunn-Tay Lee, Tsung-Hsi Wang
BACKGROUND AND PURPOSE: Recombinant tissue plasminogen activator (rtPA) is one of the proven therapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, the Ministry of Health and Welfare, Executive Yuan, Republic of China, launched the project "Hospital Emergent Capability Accreditation by Level-Stroke (HECAL-Stroke)" to improve AIS treatment in Taiwan. The current study was performed to determine whether the project launched by the government was effective in promoting rtPA therapy among AIS patients...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28559833/acute-intravenous-calcium-antagonist-for-suspected-hemiplegic-migraine-a-case-story
#7
Charlotte Lützhøft Rath, Jun He, Mette Maria Nordling, Troels Wienecke
Stroke mimics, like attacks of hemiplegic migraine, are challenging in acute stroke evaluation. We present a 28-year-old woman with a suspected hemiplegic migraine attack with left-sided hemiparalysis. Brain CT with perfusion imaging 1 h 54 min after symptom onset revealed hypoperfusion in the right hemisphere. The patient was treated with intravenous recombinant tissue plasminogen activator (rtPA) with no effect. After a subsequent intravenous verapamil infusion, the patient gained full motor function within 10 min...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28459065/optimization-of-catheter-based-rtpa-thrombolysis-in-a-novel-in-vitro-clot-model-for-intracerebral-hemorrhage
#8
Naureen Keric, Julia Masomi-Bornwasser, Hendrik Müller-Werkmeister, Sven Rainer Kantelhardt, Jochem König, Oliver Kempski, Alf Giese
Hematoma lysis with recombinant tissue plasminogen activator (rtPA) has emerged as an alternative therapy for spontaneous intracerebral hemorrhage (ICH). Optimal dose and schedule are still unclear. The aim of this study was to create a reliable in vitro blood clot model for investigation of optimal drug dose and timing. An in vitro clot model was established, using 25 mL and 50 mL of human blood. Catheters were placed into the clots and three groups, using intraclot application of rtPA, placebo, and catheter alone, were analyzed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28438515/intravenous-thrombolysis-for-acute-ischemic-stroke-in-patients-with-thrombocytopenia
#9
Ashkan Mowla, Haris Kamal, Navdeep S Lail, Caila Vaughn, Peyman Shirani, Sandhya Mehla, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Marilou Ching, Annemarie Crumlish, Robert N Sawyer
OBJECTIVE: To determine the safety of intravenous (IV) recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke (AIS) who had a platelet count <100,000 /mm(3). METHODS: We reviewed the charts of all patients who received IV rtPA for AIS during a 9.6-year period at our stroke center. Those with platelets <100,000/mm(3) were identified. Head computed tomography scans performed in 24-36 hours postthrombolysis were reviewed to evaluate the rate of symptomatic intracranial hemorrhage (sICH)...
April 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28418189/epileptic-manifestations-in-stroke-patients-treated-with-intravenous-alteplase
#10
C Bentes, H Martins, A R Peralta, C Morgado, C Casimiro, A C Franco, A C Fonseca, R Geraldes, P Canhão, T Pinho E Melo, T Paiva, J M Ferro
BACKGROUND AND PURPOSE: Intravenous alteplase (rtPA) may be associated with seizures and epileptic activity in the electroencephalogram (EEG). The aim of this work was to compare the frequency of seizures and EEG abnormalities between stroke patients treated and not treated with rtPA. METHODS: This was a prospective study of consecutive acute anterior circulation ischaemic stroke patients, with 1-year follow-up. Patients were previously independent, had an admission National Institute of Health Stroke Scale score ≥4, an acute ischaemic lesion and no previous seizures...
June 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28411103/endogenous-regeneration-engineering-growth-factors-for-stroke
#11
REVIEW
Su Jing Chan, Christopher Love, Myron Spector, Simon M Cool, Victor Nurcombe, Eng H Lo
Despite the efforts in developing therapeutics for stroke, recombinant tissue plasminogen activator (rtPA) remains the only FDA approved drug for ischemic stroke. Regenerative medicine targeting endogenous growth factors has drawn much interest in the clinical field as it provides potential restoration for the damaged brain tissue without being limited by a narrow therapeutic window. To date, most of the translational studies using regenerative medicines have encountered problems and failures. In this review, we discuss the effects of some trophic factors which include of erythropoietin (EPO), brain derived neurotrophic factor (BDNF), granulocyte-colony stimulating factor (G-CSF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), epidermal growth factor (EGF) and heparin binding epidermal growth factor (HB-EGF) in experimental ischemic stroke models and elaborate the lost in translation of the candidate growth factors from bench to bedside...
July 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28382369/fibrin-clot-characteristics-in-acute-ischaemic-stroke-patients-treated-with-thrombolysis-the-impact-on-clinical-outcome
#12
Jan P Bembenek, Maciej Niewada, Jakub Siudut, Krzysztof Plens, Anna Członkowska, Anetta Undas
Fibrin clot properties in acute ischaemic stroke (AIS) are unfavourably altered, including faster formation of denser and poorly lysable fibre networks. We investigated clot properties in AIS patients treated with recombinant tissue plasminogen activator (rtPA) and their impact on clinical outcome. In 74 consecutive AIS patients eligible for rtPA treatment, we assessed ex vivo plasma fibrin clot formation, permeability (Ks), and rtPA-induced lysis, along with peak thrombin generation, fibrinolysis proteins and inhibitors at three time points - on admission, after 24 hours and 3 months since stroke...
June 28, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28377089/patient-eligibility-for-thrombectomy-after-acute-stroke-northern-french-alps-database-analysis
#13
J Papassin, I M Favre-Wiki, T Atroun, F Tahon, K Boubagra, G Rodier, F Bing, S Marcel, C Vallot, L Belle, M Hommel, O Detante
BACKGROUND: Since 2015, the emergence of mechanical thrombectomy as standard care in acute stroke has involved organizational changes not only for stroke centers, but also for entire emergency regional networks. The aim of our study was to assess the proportion of ischemic stroke patients, admitted to stroke units in the Northern French Alps within the first 6h of onset, eligible for thrombectomy. METHODS: This study retrospectively analyzed the clinical and radiological data of all acute stroke patients hospitalized at three stroke units of the Northern French Alps Emergency Network (RENAU) in 2014...
April 1, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#14
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...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28330015/contact-aspiration-versus-stent-retriever-front-line-for-recanalisation-in-acute-cerebral-infarction-the-aster-trial
#15
Bertrand Lapergue, Julien Labreuche, Michel Piotin
RATIONALE: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO). Favorable outcome is strongly associated with the successful reperfusion status. New techniques for MT such as contact aspiration (CA) seem promising to increase reperfusion status and clinical outcome in retrospective studies. We aim at ascertaining whether CA is more efficient than stent retriever as a front-line endovascular procedure...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28322975/a-polymeric-micelle-magnetic-resonance-imaging-mri-contrast-agent-reveals-blood-brain-barrier-bbb-permeability-for-macromolecules-in-cerebral-ischemia-reperfusion-injury
#16
Kouichi Shiraishi, Zuojun Wang, Daisuke Kokuryo, Ichio Aoki, Masayuki Yokoyama
Blood-brain barrier (BBB) opening is a key phenomenon for understanding ischemia-reperfusion injuries that are directly linked to hemorrhagic transformation. The recombinant human tissue-type plasminogen activator (rtPA) increases the risk of symptomatic intracranial hemorrhages. Recent imaging technologies have advanced our understanding of pathological BBB disorders; however, an ongoing challenge in the pre-"rtPA treatment" stage is the task of developing a rigorous method for hemorrhage-risk assessments...
May 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28306132/evaluation-of-functional-outcome-measured-by-modified-rankin-scale-in-rtpa-treated-patients-with-acute-ischemic-stroke
#17
B Georgievski-Brkic, M Savic, D Nikolic, L Nikcevic, M Vukicevic, D Kozic
Aim of our study was to assess functional outcome measured by modified Rankin scale (mRS) in patients that were treated with thrombolytic therapy-recombinant tissue plasminogen activator (rtPA) after acute ischemic stroke. The study included 100 participants that were treated after acute ischemic stroke. Analyzed parameters included: gender; age groups: age 54 and below (Groupup to-54), 55-64 (Group55-64), 65-74 (Group65-74), and 75 and above (Group75-up); cerebral blood flow (CBF) and cerebral blood volume (CBV)...
December 1, 2016: Archives Italiennes de Biologie
https://www.readbyqxmd.com/read/28280989/the-role-of-pigment-epithelial-detachment-in-amd-with-submacular-hemorrhage-treated-with-vitrectomy-and-subretinal-co-application-of-rtpa-and-anti-vegf
#18
F Treumer, S Wienand, K Purtskhvanidze, J Roider, J Hillenkamp
PURPOSE: To assess the incidence of pigment epithelial detachment (PED) in age-related macular degeneration (AMD) with submacular hemorrhage (SMH) and its response to treatment with pars plana vitrectomy (ppV), subretinal co-application of recombinant tissue plasminogen activator (rtPA) and anti-VEGF, and an intravitreal gas tamponade. METHODS: Consecutive interventional case series of 132 eyes of 129 patients with neovascular AMD with SMH. All eyes underwent ppV with subretinal co-application of rtPA and bevacizumab followed by a gas tamponade...
March 9, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28275651/platelet-microparticles-a-biomarker-for-recanalization-in-rtpa-treated-ischemic-stroke-patients
#19
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/28269641/peripheral-sensory-stimulation-is-neuroprotective-in-a-rat-photothrombotic-ischemic-stroke-model
#20
Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor
Ischemic stroke is one of the leading causes of death and disability in the world. Thrombolytic therapy using recombinant tissue plasminogen activator (rtPA), the only FDA-approved drug for acute ischemia, is limited by a narrow therapeutic time window and risk of hemorrhage. There is a serious need for a neuroprotective therapy which is clinically viable. We earlier demonstrated that peripheral sensory stimulation (PSS) is a potential therapeutic intervention for hyperacute ischemia resulting in recovery of neurovascular functions when administered immediately following ischemia onset in a rat model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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