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Thrombolytic therapy

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https://www.readbyqxmd.com/read/29345016/evaluation-of-the-implementation-of-a-24-hour-stroke-thrombolysis-emergency-treatment-for-patients-with-acute-ischemic-stroke
#1
Jun Zhao, Xingqiang Li, Yingchun Liang, Liang Zhao, Xinping Zhang, Yunlin Liu
AIMS AND OBJECTIVES: To assess the trends of intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) among patients with acute ischemic stroke (AIS) admitted to our hospital between 2012 and 2014 and investigate the effects of a 24-hours (h) stroke thrombolysis emergency treatment on the intra-hospital clinical data and outcomes of these patients treated with IV rt-PA thrombolysis. BACKGROUND: Although pre-notification of stroke by emergency medical services have been endorsed by the national recommendations and implemented in some developed countries, the development in China is limited...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29338750/reperfusion-therapy-in-acute-ischemic-stroke-dawn-of-a-new-era
#2
REVIEW
Sonu Bhaskar, Peter Stanwell, Dennis Cordato, John Attia, Christopher Levi
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed...
January 16, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29327535/catheter-assisted-management-of-massive-pulmonary-embolism
#3
Amey Beedkar, Rohan Parikh, Bhavesh Patel, Mahendra Mhaske, Sunil Washimkar, Pradeep Deshmukh, Mukund Deshpande
Pulmonary thromboembolism is common and missed by clinicians. We report a case of massive pulmonary embolism which was life threatening treated by the catheter assisted technique. Anticoagulation is the mainstay of therapy for most patients, with thrombolytic therapy reserved for some patients.1 Recent studies have suggested a role for systemic or catheter-directed thrombolytic therapy in selected patients.2 We present a case of a patient who presented with an PE, was successfully treated with catheter-directed thrombolysis...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29326820/a-case-of-intra-arterial-thrombolysis-with-alteplase-in-a-patient-with-hypothenar-hammer-syndrome-but-without-underlying-aneurysm
#4
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29322705/a-comparative-study-of-in-hospital-outcome-of-patients-with-st-segment-elevation-myocardial-infarction-with-and-without-diabetes-mellitus-after-thrombolytic-therapy-in-government-hospital-of-rajkot-gujarat-india
#5
Varshit Hathi, Meghal Anadkat
Background: Diabetes mellitus is considered as a major health problem and an epidemic throughout the world. The mortality of patients with diabetes is almost twice that of non-diabetic. The outcome of in-hospital patients with myocardial infarction with and without diabetes after thrombolytic therapy is presented here. Aim: To compare the outcome of patients with myocardial infarction after thrombolysis in diabetics and non-diabetics in government hospital of Rajkot, India...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29317059/pathophysiological-significance-of-protein-hydrophobic-interactions-an-emerging-hypothesis
#6
Marek Kieliszek, Boguslaw Lipinski
Fibrinogen is a unique protein that is converted into an insoluble fibrin in a single enzymatic event, which is a characteristic feature of fibrinogen due to its susceptibility to fibrinolytic degradation and dissolution. Although thrombosis is a result of activated blood coagulation, no explanation is being offered for the persistent presence of fibrin deposits in the affected organs. A classic example is stroke, in which the thrombolytic therapy is effective only during the first 3-4 h after the onset of thrombosis...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29304529/passivating-injured-endothelium-with-kinexins-in-thrombolytic-therapy
#7
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/29301024/thrombolytic-therapy-to-the-patients-with-de-winter-electrocardiographic-pattern-is-it-right
#8
M Y Rao, Y L Wang, G R Zhang, Y Zhang, T Liu, A J Guo, L Li, K Zhou, M Wang
No abstract text is available yet for this article.
December 29, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29283052/thrombolytic-therapy-in-the-current-era-myocardial-infarction-and-beyond
#9
Patrick Proctor, Massoud A Leesar, Arka Chatterjee
Thrombolytic therapy kick-started the era of modern cardiology but in the last few decades it has been largely supplanted by primary percutaneous coronary intervention (PCI) as the go-to treatment for acute myocardial infarction. However, these agents remain important for vast populations without access to primary PCI and acute ischemic stroke. More innovative uses have recently come up for the treatment of a variety of conditions. This article summarizes the history, evidence base and current use of thrombolytics in cardiovascular disease...
December 27, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29276710/use-of-tachycardia-in-patients-with-submassive-pulmonary-emboli-to-risk-stratify-for-early-initiation-of-thrombolytic-therapy-a-case-series-comparing-early-versus-late-thrombolytic-initiation
#10
Jordana Cheta, Ashleigh Long, Paul Marik
Pulmonary embolism (PE) represents a prevalent cause of morbidity and mortality in the United States, with approximately 600 000 cases diagnosed annually. The mortality rate for untreated PE is as high as 30%. Right ventricular (RV) dysfunction is a sign of possible adverse outcomes with right-sided heart failure being the usual cause of death from PE. There is a spectrum of clinical presentations associated with PE diagnoses, from incidental and asymptomatic to rapid hemodynamic collapse. Despite successes in identifying patients with "high-risk" PEs for aggressive thrombolytic interventions and "low-risk" PEs for outpatient anticoagulation, a significant lack of consensus exists regarding intervention modalities for PEs identified as "intermediate risk" or "submassive," defined as normotensive (systolic blood pressure ≥90 mm Hg) with acute RV dysfunction and myocardial injury...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29261563/pediatric-in-hospital-cardiac-arrest-secondary-to-acute-pulmonary-embolism
#11
Ryan W Morgan, Hannah R Stinson, Heather Wolfe, Robert B Lindell, Alexis A Topjian, Vinay M Nadkarni, Robert M Sutton, Robert A Berg, Todd J Kilbaugh
OBJECTIVES: Pulmonary embolism is a rarely reported and potentially treatable cause of cardiac arrest in children and adolescents. The objective of this case series is to describe the course of five adolescent patients with in-hospital cardiac arrest secondary to pulmonary embolism. DESIGN: Case series. SETTING: Single, large academic children's hospital. PATIENTS: All patients under the age of 18 years (n = 5) who experienced an in-hospital cardiac arrest due to apparent pulmonary embolism from August 1, 2013, to July 31, 2017...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29259732/edaravone-a-synthetic-free-radical-scavenger-enhances-alteplase-mediated-thrombolysis
#12
Kiyoshi Kikuchi, Kentaro Setoyama, Ko-Ichi Kawahara, Tomoka Nagasato, Takuto Terashi, Koki Ueda, Kazuki Nakanishi, Shotaro Otsuka, Naoki Miura, Hisayo Sameshima, Kazuya Hosokawa, Yoichiro Harada, Binita Shrestha, Mika Yamamoto, Yoko Morimoto-Yamashita, Haruna Kikuchi, Ryoji Kiyama, Chinatsu Kamikokuryo, Salunya Tancharoen, Harutoshi Sakakima, Motohiro Morioka, Eiichiro Tanaka, Takashi Ito, Ikuro Maruyama
The combination of alteplase, a recombinant tissue plasminogen activator, and edaravone, an antioxidant, reportedly enhances recanalization after acute ischemic stroke. We examined the influence of edaravone on the thrombolytic efficacy of alteplase by measuring thrombolysis using a newly developed microchip-based flow-chamber assay. Rat models of embolic cerebral ischemia were treated with either alteplase or alteplase-edaravone combination therapy. The combination therapy significantly reduced the infarct volume and improved neurological deficits...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#13
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29249768/a-case-of-massive-pulmonary-embolism-following-varicose-vein-surgery-that-was-successfully-treated-with-thrombolytic-therapy
#14
Ayse Baha, Reshat Mehmet Baha, Volkan Eroglu, Aysegul Logoglu, Yahya Kemal Icen
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/29249767/high-risk-pulmonary-embolism-should-we-be-less-patient-with-thrombolytic-therapy
#15
Fatma Yıldırım, Abdullah Özer
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/29246884/mortality-of-myocardial-infarction-by-sex-age-and-obstructive-coronary-artery-disease-status-in-the-action-registry-gwtg-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#16
Nathaniel R Smilowitz, Asha M Mahajan, Matthew T Roe, Anne S Hellkamp, Karen Chiswell, Martha Gulati, Harmony R Reynolds
BACKGROUND: Sex differences in early mortality after myocardial infarction (MI) vary by age. MI with nonobstructive coronary arteries (MINOCA [<50% stenosis]) is more common among younger patients and women, and MINOCA has a better prognosis than MI with obstructive coronary artery disease (MI-CAD). The relationship between age, sex, and obstructive CAD status and outcomes post-MI has not been established. METHODS AND RESULTS: Adults who underwent coronary angiography for acute ST-segment-elevation and non-ST-segment-elevation MI in the National Cardiovascular Data Registry ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines) from 2007 to 2014 were identified...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29246609/safety-and-preliminary-efficacy-of-intravenous-tirofiban-in-acute-ischemic-stroke-patient-without-arterial-occlusion-on-neurovascular-imaging-studies
#17
Lu Lin, Wei Li, Cheng-Chun Liu, Ya Wu, Shu-Han Huang, Xiao-Shu Li, Chun-Rong Liang, Huan Wang, Li-Li Zhang, Zhi-Qiang Xu, Yan-Jiang Wang, Wuwei Feng, Meng Zhang
BACKGROUND: There has been no effective treatment for acute ischemic stroke (AIS) patients who presented to the Emergency Department >4.5h without a visible arterial occlusion on the neurovascular imaging studies. In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study...
December 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29245284/multiple-cardiac-arrests-induced-by-pulmonary-embolism-in-a-traumatically-injured-patient-a-case-report-and-review-of-the-literature
#18
Shu-Qing Sun, Ke-Peng Li, Jianming Zhi
RATIONALE: Pulmonary embolism-induced cardiac arrest should not be given up arbitrarily, knowing that the etiology of pulmonary embolism is reversible in most cases. PATIENT CONCERNS: We present a case of continuous resuscitation lasting approximately 4 hours, during which 21 episodes of cardiac arrest occurred in a 46-year-old man who sustained high-level paraplegia after a road traffic accident. DIAGNOSES: Multiple cardiac arrests induced by pulmonary embolism...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241193/comparative-analysis-on-low-and-standard-dose-regimes-of-alteplase-thrombolytic-therapy-for-acute-ischemic-stroke-efficacy-and-safety
#19
Guangjian Zhao, Tingfen Huang, Mei Zheng, Yansen Cui, Yunyong Liu, Zhongrong Cheng, Ziran Wang
OBJECTIVE: This study analyzed the efficacy and safety of low-dose and standard-dose alteplase intravenous thrombolytic therapy for acute ischemic stroke (AIS). METHODS: Patients with AIS who underwent intravenous alteplase thrombolysis from July 2012 to December 2016 were retrospectively analyzed and correspondingly divided into low-dose (0.6-0.89 mg/kg) group and standard-dose group (0.9 mg/kg) according to alteplase dosage. The clinical outcome was evaluated by modified Rankin Scale (mRS) at 90 days after onset...
December 14, 2017: European Neurology
https://www.readbyqxmd.com/read/29226949/thrombolysis-for-acute-upper-extremity-deep-vein-thrombosis
#20
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Janus C Jakobsen
BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. OBJECTIVES: To assess the beneficial and harmful effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis...
December 11, 2017: Cochrane Database of Systematic Reviews
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