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Thrombolytic therapy

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https://www.readbyqxmd.com/read/28548010/initial-experience-with-the-6-f-and-8-f-indigo-thrombectomy-system-for-acute-renovisceral-occlusive-events
#1
Theodosios Bisdas, Konstantinos Stavroulakis, Efthymios Beropoulis, Arne Schwindt, Arne Stachmann, Martin Austermann, Giovanni Torsello
PURPOSE: To examine the safety and effectiveness of the new large-bore Indigo thrombectomy catheters to treat patients with acute renovisceral occlusion without the need of thrombolytic agents. METHODS: Between November 2015 and 2016, 7 consecutive patients (mean age 65±5 years; 5 men) with acute renovisceral artery occlusion were treated with the new large-bore (6-F and 8-F) vacuum-assisted thrombectomy catheters. The occluded vessels were 6 renal arteries and 3 superior mesenteric arteries (SMAs); 5 of the 9 thromboses were in bridging stent-grafts associated with branched endografts...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28546045/intravenous-targeted-microbubbles-carrying-urokinase-versus-urokinase-alone-in-acute-peripheral-arterial-thrombosis-in-a-porcine-model
#2
Johanna H Nederhoed, Harm P Ebben, Jeroen Slikkerveer, Arjan Wj Hoksbergen, Otto Kamp, Geert-Jan Tangelder, Willem Wisselink, René Jp Musters, Kak K Yeung
PURPOSE: Standard therapy in acute peripheral arterial occlusion consists of intra-arterial catheter guided thrombolysis. As microbubbles may be used as a carrier for fibrinolytic agents and targeted to adhere to the thrombus, we can theoretically deliver the thrombolytic medication locally following simple intravenous injection. In this intervention-controlled feasibility study, we compared intravenously administered targeted microbubbles incorporating Urokinase and locally applied ultrasound, with intravenous Urokinase and ultrasound alone...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28545283/-clinical-efficacy-and-safety-of-thrombolytic-treatment-with-reteplase-in-patients-with-intermediate-risk-acute-pulmonary-embolism
#3
H G Zhao, S X Wang, Z N Lu, X X Yan, Z C Lyu, F H Peng, Y Wu, X Gao, L Hua, Z C Jing, X Q Xu
Objective: To assess the efficacy and safety of thrombolytic treatment with reteplase in patients with intermediate-risk acute pulmonary embolism. Methods: Ten consecutive patients with intermediate-risk acute pulmonary embolism who received thrombolytic treatment with reteplase at Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and biochemical markers were assessed before and after thrombolytic therapy with reteplase, and bleeding complications were also observed during 3 months follow up...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28545055/comparative-lytic-efficacy-of-rt-pa-and-ultrasound-in-porcine-versus-human-clots
#4
Shenwen Huang, Himanshu Shekhar, Christy K Holland
INTRODUCTION: Porcine thrombi are employed routinely in preclinical models of ischemic stroke. In this study, we examined the differential lytic susceptibility of porcine and human whole blood clots with and without the use of microbubbles and ultrasound (US) as an adjuvant. MATERIALS AND METHODS: An in vitro system equipped with time-lapse microscopy was used to evaluate recombinant tissue-plasminogen activator (rt-PA) lysis of porcine and human clots in the same species or cross species plasma...
2017: PloS One
https://www.readbyqxmd.com/read/28541023/correlation-between-biological-characteristics-of-thrombus-and-short-term-efficiency-of-thrombolytic-therapy-by-acoustic-radiation-force-impulse-imaging-technique
#5
Xiaolei Yi, Caifang Ni, Mingming Li, Qiong Wu, Yi Li
BACKGROUND: Evaluate the biological characteristics of lower extremity deep venous thrombosis by applying acoustic radiation force impulse imaging technique(ARFI), explore the correlation between the value of shear wave speed (SWV) and short-term efficacy of thrombolytic therapy as well as analyze the application value of shear wave velocity in predicting the short-term efficacy of thrombolytic therapy. METHODS: Examine acoustic radiation force impulse imaging for 120 patients with lower extremity deep venous thrombosis and measure the shear wave velocity values...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28535201/regulatory-t-cells-ameliorate-tissue-plasminogen-activator-induced-brain-haemorrhage-after-stroke
#6
Leilei Mao, Peiying Li, Wen Zhu, Wei Cai, Zongjian Liu, Yanling Wang, Wenli Luo, Ruth A Stetler, Rehana K Leak, Weifeng Yu, Yanqin Gao, Jun Chen, Gang Chen, Xiaoming Hu
Delayed thrombolytic treatment with recombinant tissue plasminogen activator (tPA) may exacerbate blood-brain barrier breakdown after ischaemic stroke and lead to lethal haemorrhagic transformation. The immune system is a dynamic modulator of stroke response, and excessive immune cell accumulation in the cerebral vasculature is associated with compromised integrity of the blood-brain barrier. We previously reported that regulatory T cells, which function to suppress excessive immune responses, ameliorated blood-brain barrier damage after cerebral ischaemia...
May 22, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28513852/effect-of-pentoxifylline-in-ameliorating-myocardial-injury-in-patients-with-myocardial-infarction-undergoing-thrombolytic-therapy-a-pilot-randomized-clinical-trial
#7
Hossein Namdar, Rasoul Zohori, Naser Aslanabadi, Taher Entezari-Maleki
Cell death following acute myocardial infarction (MI) is the hallmark pathology of cardiovascular disease, leading to considerable mortality and morbidity. Platelet and neutrophil activation and inflammatory cytokines, prominently TNF-α, play an important role in the development of cell death. Because pentoxifylline inhibits platelet and neutrophil activation and reduces TNF-α, this study was performed to assess the potential benefit of pentoxifylline in the reduction of myocardial injury following acute MI...
May 17, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28511806/st-segment-elevation-myocardial-infarction-could-be-the-primary-presentation-of-acute-aortic-dissection
#8
Qing-Yi Zhu, Shi Tai, Liang Tang, Wen Peng, Sheng-Hua Zhou, Zhen-Guo Liu, Xin-Qun Hu
BACKGROUND: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. METHODS: The records were reviewed for patients admitted to the large comprehensive university hospital for PCI due to STEMI from January 1, 2002 to January 1, 2017...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28503386/mechanical-thrombectomy-for-acute-ischemic-stroke-after-cardiac-surgery
#9
Ali S Haider, Prabhat Garg, Ian T Watson, Dean Leonard, Umair Khan, Ahmed Haque, Phu Nguyen, Kennith F Layton
Ischemic stroke is a rare yet devastating complication that may occur following cardiothoracic surgery. Fibrinolytic treatment is contraindicated due to elevated risk for hemorrhage. Mechanical thrombectomy entails a catheterized approach wherein the thrombus is physically removed from the vessel without the use of fibrinolytics, minimizing the possibility of intracranial hemorrhage. Here, we present two original cases of mechanical thrombectomy as treatment for patients experiencing emergent large vessel occlusion following cardiothoracic surgery...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28501664/systemic-thrombolytic-therapy-and-catheter-directed-fragmentation-with-local-thrombolytic-therapy-in-patients-with-pulmonary-embolism
#10
Julia Klevanets, Vladimir Starodubtsev, Pavel Ignatenko, Olga Voroshilina, Pavel Ruzankin, Andrey Karpenko
The objective was to compare immediate and long-term results of systemic thrombolytic therapy (STT) and catheter-directed fragmentation (CDF) with local thrombolytic therapy (LTT) in patients with massive pulmonary embolism (PE). METHODS: 209 patients with massive PE (the high risk of early death) were included in our study. From 2008 till 2010 in the first group (n=102) STT was performed. From 2011 till 2013 in the second group (n=107) CDF with LTT was carried out. Echocardiography and pulmonary arteriography were performed in all patients on admission to hospital and in 5 days after treatment...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28500420/purification-biochemical-and-structural-characterization-of-a-novel-fibrinolytic-enzyme-from-mucor-subtilissimus-ucp-1262
#11
Thiago Pajeú Nascimento, Amanda Emmanuelle Sales, Tatiana Souza Porto, Romero Marcos Pedrosa Brandão Costa, Leonid Breydo, Vladimir N Uversky, Ana Lúcia Figueiredo Porto, Attilio Converti
Fibrinolytic proteases are enzymes that degrade fibrin. They provide a promising alternative to existing drugs for thrombolytic therapy. A protease isolated from the filamentous fungus Mucor subtilissimus UCP 1262 was purified in three steps by ammonium sulfate fractionation, ion exchange, and molecular exclusion chromatographies, and characterized biochemically and structurally. The purified protease exhibited a molecular mass of 20 kDa, an apparent isoelectric point of 4.94 and a secondary structure composed mainly of α-helices...
May 12, 2017: Bioprocess and Biosystems Engineering
https://www.readbyqxmd.com/read/28498107/ultrasound-assisted-thrombolysis-of-an-occluded-transjugular-portosystemic-shunt
#12
Nicholas Hilliard, Teik Choon See, Nadeem Shaida
Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Ultrasound-assisted thrombolysis has been shown to be successful for treatment of pulmonary embolism, deep vein thrombosis, and peripheral arterial thromboembolism, but has not been described before for TIPS occlusion...
May 12, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28489130/impact-of-coronary-intensive-care-unit-in-treatment-of-myocardial-infarction
#13
Marcia Cristina Todo, Carolina Marabesi Bergamasco, Paula Schmidt Azevedo, Marcos Ferreira Minicucci, Roberto Minoru Tanni Inoue, Marina Politi Okoshi, Sergio Rupp de Paiva, Leonardo Mamede Zornoff, Bertha Furlan Polegato
Introduction: The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI) has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU). The aim of this study was to evaluate the effect of CICU implementation on prescribed recommended treatments and mortality 30 days after STEMI. Method: We performed a retrospective study with patients admitted to CICU between 2005 and 2006 (after group) and between 2000 and 2002, before CICU implementation (before group)...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28487554/improved-thrombolytic-effect-with-focused-ultrasound-and-neuroprotective-agent-against-acute-carotid-artery-thrombosis-in-rat
#14
Tsong-Hai Lee, Jih-Chao Yeh, Chih-Hung Tsai, Jen-Tsung Yang, Shyh-Liang Lou, Chen-June Seak, Chao-Yung Wang, Kuo-Chen Wei, Hao-Li Liu
Combination therapy with focused ultrasound (FUS) and a neuroprotective agent, BNG-1, was examined in an acute carotid thrombotic occlusion model using LED irradiation in rat to improve the thrombolytic effect of rt-PA. Seven treatment groups included (A) intravenous bolus injection of 0.45 mg/kg rt-PA, (B) intravenous bolus injection of 0.9 mg/kg, (C) sonothrombolysis with FUS alone, (D) oral administration of 2 g/kg BNG-1 for 7 days alone, (E) A + D, (F) A + C, and (G) A + C + D. Four comparison groups were made including (H) 0...
May 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28484963/blood-brain-barrier-protection-as-a-therapeutic-strategy-for-acute-ischemic-stroke
#15
Ali Ehsan Sifat, Bhuvaneshwar Vaidya, Thomas J Abbruscato
The blood-brain barrier (BBB) is a vital component of the neurovascular unit (NVU) containing tight junctional (TJ) proteins and different ion and nutrient transporters which maintain normal brain physiology. BBB disruption is a major pathological hallmark in the course of ischemic stroke which is regulated by the actions of different factors working at different stages of cerebral ischemia including matrix metalloproteinases (MMPs), inflammatory modulators, vesicular trafficking, oxidative pathways, and junctional-cytoskeletal interactions...
May 8, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28479799/advanced-age-and-higher-national-institutes-of-health-stroke-scale-score-as-predictors-of-poor-outcome-in-ischemic-stroke-patients-treated-with-alteplase-a-study-from-a-tertiary-care-centre-in-rural-north-west-india
#16
Amit Bhardwaj, Girish Sharma, Sunil Kumar Raina, Ashish Sharma, Monica Angra
INTRODUCTION: Thrombolytic therapy in acute ischemic stroke has been approved for treatment of acute stroke for past two decades. However, identification of predictors of poor outcome after the intravenous (IV) alteplase therapy in acute stroke patients is a matter of research. The present study was conducted with the aim of identifying poor prognostic factors in patients of acute ischemic stroke patients. METHODS: The data of 31 acute stroke patients treated with alteplase were gathered to identify the factors that were independent predictors of the poor outcome...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28479425/thrombolytic-therapy-of-acute-massive-pulmonary-embolism-using-swan-ganz-pulmonary-artery-catheter
#17
Ilse Espina, Joseph Varon, Peter H Lin
Acute massive pulmonary embolism (PE) is associated with high fatality, and catheter-directed thrombolytic therapy has been shown to be an efficacious treatment for this condition. We herein report a patient who developed acute massive PE but could not undergo the conventional catheter-directed thrombolytic therapy. A Swan-Ganz pulmonary artery catheter was placed at bedside to initiate immediate thrombolytic infusion, which resulted in dramatic clinical improvement. This report underscores a potential role of thrombolytic therapy via a trans-jugular pulmonary artery catheter in patients with acute massive PE who could not undergo the conventional catheter-based thrombolytic intervention...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479184/systemic-thrombolysis-in-acute-ischemic-stroke-after-dabigatran-etexilate-reversal-with-idarucizumab-a-case-report
#18
Derya Tireli, Jun He, Mette Maria Nordling, Troels Wienecke
INTRODUCTION: Idarucizumab is a reversal agent for dabigatran etexilate. By reversing the anticoagulating effect of dabigatran etexilate with idarucizumab (Praxbind), patients presenting with an acute ischemic stroke can now be eligible for thrombolysis. PATIENT: We describe our experience with idarucizumab in a 71-year-old male patient pretreated with dabigatran etexilate. The patient arrived with a hemiparesis, central facial palsy, and dysarthria. METHOD: Dabigatran etexilate was antagonized with idarucizumab, approximately 2...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28473083/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-mesenteric-ischemia
#19
Nicholas Fidelman, Ali F AbuRahma, Brooks D Cash, Baljendra S Kapoor, M-Grace Knuttinen, Jeet Minocha, Paul J Rochon, Colette M Shaw, Charles E Ray, Jonathan M Lorenz
Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Recommended therapy for chronic mesenteric ischemia includes angioplasty with or without stent placement and, if an endovascular approach is not possible, surgical bypass or endarterectomy...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28470393/aortic-aneurysm-rupture-after-urokinase-treatment-for-acute-limb-ischemia-in-two-patients-after-evar
#20
Davy R Sudiono, Rigo Hoencamp, Jaap Ottevanger, Daniel Eefting, Edwin van der Linden
Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. These cases suggest a relation between thrombolytic therapy and aortic rupture after EVAR, and we should therefore be aware of this possible complication...
May 3, 2017: Cardiovascular and Interventional Radiology
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