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Thrombolysis, stroke, ischemia

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https://www.readbyqxmd.com/read/29933207/multi-targeting-effects-of-a-new-synthetic-molecule-jm-20-in-experimental-models-of-cerebral-ischemia
#1
REVIEW
Yanier Nuñez-Figueredo, Jeney Ramírez-Sánchez, Gilberto L Pardo Andreu, Estael Ochoa-Rodríguez, Yamila Verdecia-Reyes, Diogo O Souza
Ischemic stroke is a major cause of death and disability worldwide. Thrombolysis by tissue plasminogen activator is the only pharmacological treatment approved for clinical practice, but has a narrow therapeutic window and poor efficacy when the cell death cascade is activated. Numerous drugs that are thought to protect neurons against injury have previously failed in human trials despite showing efficacy in experimental models of stroke. Herein, we reviewed the main pre-clinical results of the neuroprotective effects of JM-20, a new hybrid molecule, against brain ischemia...
February 12, 2018: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29908420/ticagrelor-versus-clopidogrel-after-fibrinolytic-therapy-in-patients-with-st-elevation-myocardial-infarction-rationale-and-design-of-the-ticagrelor-in-patients-with-st-elevation-myocardial-infarction-treated-with-thrombolysis-treat-trial
#2
Otavio Berwanger, Jose C Nicolau, Antonio C Carvalho, Lixin Jiang, Shaun Goodman, Stephen J Nicholls, Alexander Parkhomenko, Oleg Averkov, Carlos Tajer, Germán Malaga, Jose F Kerr Saraiva, Francisco Fonseca, Helio P Guimaraes, Pedro G M de Barros E Silva, Lucas P Damiani, Denise M Paisani, Camila M R Lasagno, Carolina T Candido, Nanci Valeis, Diogo D F Moia, Leopoldo S Piegas, Christopher B Granger, Harvey White, Renato D Lopes
BACKGROUND: The safety and efficacy of ticagrelor in patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remain uncertain. OBJECTIVES: The primary objective of the TicagRElor in pAtients with ST elevation myocardial infarction treated with Thrombolysis (TREAT) trial is to evaluate the short-term safety of ticagrelor when compared with clopidogrel in STEMI patients treated with fibrinolytic therapy. Key secondary objectives are to assess the safety and efficacy of ticagrelor compared with clopidogrel at 12-months...
March 3, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29895187/factor-viii-in-acute-cerebral-ischemia-pilot-study-biomarker-in-patients-with-large-vessel-occlusion
#3
Digvijaya Navalkele, Amelia Boehme, Karen Albright, Cindy Leissinger, Laurie Schluter, Melissa Freeman, Stacy Drury, Ramy El Khoury, T Mark Beasley, Sheryl Martin-Schild
We conducted a prospective serial laboratory cohort study to assess the correlation of factor VIII (FVIII) levels in response to thrombolysis in patients with large vessel occlusion (LVO) and acute ischemic stroke (AIS). Patients with AIS with anterior circulation LVO were eligible for enrollment if treated within 4.5 hours from last seen normal with intravenous tissue plasminogen activator (tPA). Patients (n = 29) had a mean age of 71 years and median National Institute of Health Stroke Scale of 14. Baseline pre-tPA FVIII was not significantly correlated with clot burden score (-0...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29887594/the-role-of-von-willebrand-factor-adamts13-and-cerebral-artery-thrombus-composition-in-patient-outcome-following-mechanical-thrombectomy-for-acute-ischemic-stroke
#4
Vaclav Prochazka, Tomas Jonszta, Daniel Czerny, Jan Krajca, Martin Roubec, Jirka Macak, Petr Kovar, Petra Kovarova, Martin Pulcer, Renata Zoubkova, Ivo Lochman, Veronika Svachova, Lubomir Pavliska, Adela Vrtkova, David Kasprak, Jaromir Gumulec, John W Weisel
BACKGROUND The aim of the study was to investigate the role of von Willebrand factor (vWF), the vWF-cleaving protease, ADAMTS13, the composition of thrombus, and patient outcome following mechanical cerebral artery thrombectomy in patients with acute ischemic stroke. MATERIAL AND METHODS A prospective cohort study included 131 patients with ischemic stroke (<6 hours) with or without intravenous thrombolysis. Interventional procedure parameters, hemocoagulation markers, vWF, ADAMTS13, and histological examination of the extracted thrombi were performed...
June 11, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29886671/-sole-angioplasty-with-tiny-balloon-for-high-risk-complex-symptomatic-intracranial-atherosclerotic-stenosis
#5
P Qi, J J Wang, L J Wang, J Lu, S Hu, X M Yang, K P Chen, H F Wang, D M Wang
Objective: To explore the safety and short-term efficacy of sole angioplasty with tiny balloon for symptomatic intracranial atherosclerotic stenosis (ICAS) patients with complex lesions refractory. Methods: Consecutive 11 patients with complex ICAS lesions treated by sole angioplasty with tiny balloon (diameter≤2 mm) from September 2016 to November 2017 at Department of Neurosurgery, Beijing Hospital were retrospectively reviewed. Patients' demographics, lesions characteristics, procedures, complications, and clinical and imaging follow-up data were collected...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29867718/reperfusion-and-clinical-outcomes-in-acute-ischemic-stroke-systematic-review-and-meta-analysis-of-the-stent-retriever-based-early-window-endovascular-stroke-trials
#6
Nathan W Manning, Charles D Warne, Philip M Meyers
Objective: To explore the effects of reperfusion grade rates on clinical outcomes in the setting of stent-retriever-based reperfusion therapy for anterior circulation stroke in early time windows. Methods: Systematic searching of Medline and Embase databases was performed to identify stroke trials of stent-retriever-based therapy versus standard care. Mixed effects meta-regression was used to analyze the trial-level association between reperfusion rates and clinical outcomes...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#7
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29766770/mri-guided-thrombolysis-for-stroke-with-unknown-time-of-onset
#8
Götz Thomalla, Claus Z Simonsen, Florent Boutitie, Grethe Andersen, Yves Berthezene, Bastian Cheng, Bharath Cheripelli, Tae-Hee Cho, Franz Fazekas, Jens Fiehler, Ian Ford, Ivana Galinovic, Susanne Gellissen, Amir Golsari, Johannes Gregori, Matthias Günther, Jorge Guibernau, Karl Georg Häusler, Michael Hennerici, André Kemmling, Jacob Marstrand, Boris Modrau, Lars Neeb, Natalia Perez de la Ossa, Josep Puig, Peter Ringleb, Pascal Roy, Enno Scheel, Wouter Schonewille, Joaquin Serena, Stefan Sunaert, Kersten Villringer, Anke Wouters, Vincent Thijs, Martin Ebinger, Matthias Endres, Jochen B Fiebach, Robin Lemmens, Keith W Muir, Norbert Nighoghossian, Salvador Pedraza, Christian Gerloff
Background Under current guidelines, intravenous thrombolysis is used to treat acute stroke only if it can be ascertained that the time since the onset of symptoms was less than 4.5 hours. We sought to determine whether patients with stroke with an unknown time of onset and features suggesting recent cerebral infarction on magnetic resonance imaging (MRI) would benefit from thrombolysis with the use of intravenous alteplase. Methods In a multicenter trial, we randomly assigned patients who had an unknown time of onset of stroke to receive either intravenous alteplase or placebo...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29765502/the-phenolic-components-of-gastrodia-elata-improve-prognosis-in-rats-after-cerebral-ischemia-reperfusion-by-enhancing-the-endogenous-antioxidant-mechanisms
#9
Anhuan Shi, Jianming Xiang, Fangyan He, Yanping Zhu, Gongbei Zhu, Yuhan Lin, Ningna Zhou
Pharmacological or spontaneous thrombolysis in ischemic stroke triggers an outbreak of reactive oxygen species and results in neuron death. Nrf2-mediated antioxidation in cells has been proved as a pivotal target for neuroprotection. This research reports that phenolic components of Gastrodia elata Blume (PCGE), a traditional Chinese medicine, can alleviate the pathological lesions in the penumbra and hippocampus by increasing the survival of neurons and astrocytes and improve neurofunction and cognition after reperfusion in a rat model of middle cerebral artery occlusion...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29754671/rationale-and-design-for-the-vascular-outcomes-study-of-asa-along-with-rivaroxaban-in-endovascular-or-surgical-limb-revascularization-for-peripheral-artery-disease-voyager-pad
#10
Warren H Capell, Marc P Bonaca, Mark R Nehler, Edmond Chen, John M Kittelson, Sonia S Anand, Scott D Berkowitz, Eike Sebastian Debus, Fabrizio Fanelli, Lloyd Haskell, Manesh R Patel, Rupert Bauersachs, William R Hiatt
BACKGROUND: Patients with peripheral artery disease (PAD) undergoing a lower-extremity revascularization are at heightened risk for ischemic cardiac and limb events. Although intensification of antithrombotic therapy after revascularization has demonstrated benefit in coronary disease populations, this approach has not been well studied or shown consistent benefit in PAD. Recent trial evidence demonstrated that a treatment strategy of rivaroxaban added to background antiplatelet therapy reduced ischemic risk in patients following recent acute coronary syndromes, as well as in patients with stable atherosclerotic vascular disease...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29725905/jm-20-treatment-after-mcao-reduced-astrocyte-reactivity-and-neuronal-death-on-peri-infarct-regions-of-the-rat-brain
#11
Jeney Ramírez-Sánchez, Elisa Nicoloso Simões Pires, André Meneghetti, Gisele Hansel, Yanier Nuñez-Figueredo, Gilberto L Pardo-Andreu, Estael Ochoa-Rodríguez, Yamila Verdecia-Reyes, René Delgado-Hernández, Christianne Salbego, Diogo O Souza
Stroke is frequently associated with severe neurological decline and mortality, and its incidence is expected to increase due to aging population. The only available pharmacological treatment for cerebral ischemia is thrombolysis, with narrow therapeutic windows. Efforts aimed to identify new therapeutics are crucial. In this study, we look into plausible molecular and cellular targets for JM-20, a new hybrid molecule, against ischemic stroke in vivo. Male Wistar rats were subjected to 90 min middle cerebral artery occlusion (MCAO) following 23 h of reperfusion...
May 3, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29706296/stent-retriever-thrombectomy-for-acute-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-including-thrace
#12
M Barral, S Boudour, M Viprey, C Giroudon, G Aulagner, A-M Schott, F Turjman, X Armoiry, B Gory
BACKGROUND AND PURPOSE: Endovascular thrombectomy has become the reference therapy for patients with large vessel occlusion (LVO). However, no meta-analysis including the THRACE Trial has yet been reported. Thus, the present review assessed the outcomes of stent retriever thrombectomy added to medical care compared with medical care alone in LVO patients. MATERIALS AND METHODS: A systematic review was conducted of all randomized controlled trials (RCTs) examining stent retrievers added to medical care vs medical care alone in the MEDLINE, Embase and Web of Science databases...
May 2018: Revue Neurologique
https://www.readbyqxmd.com/read/29651748/improved-reperfusion-and-vasculoprotection-by-the-poly-adp-ribose-polymerase-inhibitor-pj34-after-stroke-and-thrombolysis-in-mice
#13
Mohamad El Amki, Dominique Lerouet, Marie Garraud, Fei Teng, Virginie Beray-Berthat, Bérard Coqueran, Benoît Barsacq, Charlotte Abbou, Bruno Palmier, Catherine Marchand-Leroux, Isabelle Margaill
Benefits from thrombolysis with recombinant tissue plasminogen activator (rt-PA) after ischemic stroke remain limited due to a narrow therapeutic window, low reperfusion rates, and increased risk of hemorrhagic transformations (HT). Experimental data showed that rt-PA enhances the post-ischemic activation of poly(ADP-ribose)polymerase (PARP) which in turn contributes to blood-brain barrier injury. The aim of the present study was to evaluate whether PJ34, a potent PARP inhibitor, improves poor reperfusion induced by delayed rt-PA administration, exerts vasculoprotective effects, and finally increases the therapeutic window of rt-PA...
April 12, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29643261/primary-results-of-the-multicenter-arise-ii-study-analysis-of-revascularization-in-ischemic-stroke-with-embotrap
#14
Osama O Zaidat, Hormozd Bozorgchami, Marc Ribó, Jeffrey L Saver, Heinrich P Mattle, René Chapot, Ana Paula Narata, Olivier Francois, Ashutosh P Jadhav, Jonathan A Grossberg, Christian H Riedel, Alejandro Tomasello, Wayne M Clark, Hannes Nordmeyer, Eugene Lin, Raul G Nogueira, Albert J Yoo, Tudor G Jovin, Adnan H Siddiqui, Thierry Bernard, Mairsíl Claffey, Tommy Andersson
BACKGROUND AND PURPOSE: EmboTrap is a novel stent retriever designed to achieve rapid and substantial flow restoration in acute ischemic stroke secondary to large-vessel occlusions. Here, we evaluated EmboTrap's safety and efficacy compared with established stent retrievers. METHODS: ARISE II (Analysis of Revascularization in Ischemic Stroke With EmboTrap) was a single-arm, prospective, multicenter study, comparing the EmboTrap device to a composite performance goal criterion derived using a Bayesian meta-analysis from the pivotal SWIFT (Solitaire device) and TREVO 2 (Trevo device) trials...
May 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29567761/scil-stroke-subcutaneous-interleukin-1-receptor-antagonist-in-ischemic-stroke-a-randomized-controlled-phase-2-trial
#15
Craig J Smith, Sharon Hulme, Andy Vail, Calvin Heal, Adrian R Parry-Jones, Sylvia Scarth, Karen Hopkins, Margaret Hoadley, Stuart M Allan, Nancy J Rothwell, Stephen J Hopkins, Pippa J Tyrrell
BACKGROUND AND PURPOSE: The proinflammatory cytokine IL-1 (interleukin-1) has a deleterious role in cerebral ischemia, which is attenuated by IL-1 receptor antagonist (IL-1Ra). IL-1 induces peripheral inflammatory mediators, such as interleukin-6, which are associated with worse prognosis after ischemic stroke. We investigated whether subcutaneous IL-1Ra reduces the peripheral inflammatory response in acute ischemic stroke. METHODS: SCIL-STROKE (Subcutaneous Interleukin-1 Receptor Antagonist in Ischemic Stroke) was a single-center, double-blind, randomized, placebo-controlled phase 2 trial of subcutaneous IL-1Ra (100 mg administered twice daily for 3 days) in patients presenting within 5 hours of ischemic stroke onset...
May 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29535270/posttreatment-national-institutes-of-health-stroke-scale-is-superior-to-the-initial-score-or-thrombolysis-in-cerebral-ischemia-for-3-month-outcome
#16
Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae
BACKGROUND AND PURPOSE: The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status. METHODS: We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29487654/successful-carotid-thrombus-aspiration-middle-cerebral-mechanical-thrombectomy-and-axillary-artery-clot-disruption-attempt-in-a-patient-with-acute-ischemic-stroke-and-critical-upper-limb-ischemia
#17
Anton A Khilchuk, Sergey V Vlasenko, Sergey G Scherbak, Andrey M Sarana, Vitaliy V Popov
Acute thrombotic occlusions of the large vessels, such as internal carotid artery, arms and legs arteries, and intracranial vessels, frequently require multiple techniques such as selective thrombolysis, manual aspiration, and stent retrievers for mechanical thrombectomy with combination of the mentioned techniques. Because of the massive thrombotic burden associated with these conditions, the response to systemic intravenous thrombolysis is poor. We present a case of a successful massive thrombi aspiration in a single attempt using an 8Fr guide catheter with aspiration syringe, subsequent ipsilateral middle cerebral artery mechanical thrombectomy, and axillary artery clot disruption attempt in a patient with acute ischemic stroke, right arm critical ischemia, and persistent atrial fibrillation...
February 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29387392/effect-of-recombinant-human-prourokinase-on-thrombolysis-in-a-rabbit-model-of-thromboembolic-stroke
#18
Chunhua Hao, Wenxia Ding, Xiangwei Xu, Qian Sun, Xinxin Li, Weiting Wang, Zhuanyou Zhao, Lida Tang
The aim of the present study was to investigate the efficacy of recombinant human prourokinase (rhPro-UK) on thromboembolic stroke in rabbits. A total of 210 rabbits were used in experiments. The 180 thromboembolic stroke rabbits were divided into three therapeutic time windows with six groups in each time window (n=10). The model group was administered saline, the reagent groups were administered rhPro-UK (2.5×, 5× and 10×104 U/kg), and the positive control groups were administered 5×104 urokinase (UK) U/kg and 4...
January 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29349384/acute-hemifacial-ischemia-as-a-late-complication-of-carotid-stenting
#19
Maurizio Domanin, Maurizio Isalberti, Silvia Romagnoli, Antonio Rolli, Simona Sommaruga
Concerns about carotid artery stenting (CAS) center primarily on procedural complications like acute occlusion, stroke, and long-term intrastent restenosis. External carotid artery (ECA) thrombosis is observed during CAS follow-up, but it often remains asymptomatic or, at worst, results in jaw claudication. We report here a case of late occlusion of the ECA after CAS with symptoms of acute homolateral facial ischemia as well as pain, cyanosis, tongue numbness, and skin coldness. The patient was submitted to local thrombolysis and balloon angioplasty with regression of symptoms after recanalization...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29322481/influence-of-thrombolysis-on-the-safety-and-efficacy-of-blocking-platelet-adhesion-or-secretory-activity-in-acute-ischemic-stroke-in-mice
#20
Michael K Schuhmann, Peter Kraft, Michael Bieber, Axel Haarmann, György A Homola, Mirko Pham, Bernhard Nieswandt, Guido Stoll
In acute ischemic stroke (AIS), there is an alarming discrepancy between recanalization rates of up to 70% by combined recombinant tissue-type plasminogen activator (rt-PA) therapy and mechanical thrombectomy, and no clinical benefit in at least every second stroke patient. This is partly due to ischemia/reperfusion (I/R) injury. In a translational approach, we used mice lacking dense- (Unc13d -/- ) or α-granules (Nbeal2 -/- ) and mice after blocking of platelet glycoprotein receptor (GP) Ib conferring protection from I/R injury...
January 10, 2018: Translational Stroke Research
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