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Thrombolysis associated intracerebral hemorrhage

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https://www.readbyqxmd.com/read/29131095/intracranial-internal-carotid-artery-wall-calcification-in-ischemic-strokes-treated-with-thrombolysis
#1
Miguel Tábuas-Pereira, João Sargento-Freitas, Fernando Silva, Joana Parra, Patrícia Mendes, Vera Seara, Miguel Mesquita, Mariana Baptista, Gustavo Cordeiro, Luis Cunha
BACKGROUND: Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications. OBJECTIVES: To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death...
November 13, 2017: European Neurology
https://www.readbyqxmd.com/read/29127269/intracerebral-hemorrhage-and-outcome-after-thrombolysis-in-stroke-patients-using-selective-serotonin-reuptake-inhibitors
#2
Jan F Scheitz, Guillaume Turc, Linda Kujala, Alexandros A Polymeris, Mirjam R Heldner, Thomas P Zonneveld, Hebun Erdur, Sami Curtze, Christopher Traenka, Céline Brenière, Roland Wiest, Andrea Rocco, Gerli Sibolt, Henrik Gensicke, Matthias Endres, Nicolas Martinez-Majander, Yannick Béjot, Paul J Nederkoorn, Catherine Oppenheim, Marcel Arnold, Stefan T Engelter, Daniel Strbian, Christian H Nolte
BACKGROUND AND PURPOSE: Selective serotonin-reuptake inhibitors (SSRIs) impair platelet function and have been linked to a higher risk of spontaneous intracerebral hemorrhage-an association that may be augmented by oral anticoagulants (OAC). We aimed to assess whether preadmission treatment with SSRIs in patients with acute ischemic stroke is associated with post-thrombolysis symptomatic intracerebral hemorrhage (sICH) and functional outcome. METHODS: A multicenter retrospective analysis was conducted in prospective registries of patients treated by thrombolysis within 4...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29115734/more-extensive-white-matter-hyperintensity-is-linked-with-higher-risk-of-remote-intracerebral-hemorrhage-after-intravenous-thrombolysis
#3
Yi Chen, Shenqiang Yan, Mengjun Xu, Genlong Zhong, David S Liebeskind, Min Lou
BACKGROUND AND PURPOSES: Remote intracerebral hemorrhage (rICH) is infrequent after intravenous thrombolysis (IVT) and its mechanism remains poorly understood. We aim to assess its frequency and possible relationship with the severity of white matter hyperintensity (WMH) in acute ischemic stroke (AIS) patients. METHODS: We prospectively analyzed data from consecutive AIS patients with MRI and IVT. WMH volume was quantitatively measured. rICH was defined as intracranial hemorrhage that appears in brain regions without visible ischemic changes on 24h follow-up imaging...
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29084408/influence-of-renal-function-on-treatment-results-after-stroke-thrombectomy
#4
Mona Laible, Markus Alfred Möhlenbruch, Johannes Pfaff, Ekkehart Jenetzky, Peter Arthur Ringleb, Martin Bendszus, Timolaos Rizos
BACKGROUND: Renal dysfunction (RD) may be associated with poor outcome in ischemic stroke patients treated with mechanical thrombectomy (MT), but data concerning this important and emerging comorbidity do not exist so far. Here, we investigated the influence of RD on postprocedural intracerebral hemorrhage (ICH), clinical outcome, and mortality in a large prospectively collected cohort of acute ischemic stroke patients treated with MT. METHODS: Consecutive patients with anterior-circulation stroke treated with MT between October 2010 and January 2016 were included...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28887393/white-matter-hyperintensity-volume-and-outcome-of-mechanical-thrombectomy-with-stentriever-in-acute-ischemic-stroke
#5
Kunakorn Atchaneeyasakul, Thabele Leslie-Mazwi, Kathleen Donahue, Anne-Katrin Giese, Natalia S Rost
BACKGROUND AND PURPOSE: Finding of white matter hyperintensity (WMH) has been associated with an increased risk of parenchymal hematoma and poor clinical outcomes after mechanical thrombectomy using old-generation endovascular devices. Currently, no data exist with regard to the risk of mechanical thrombectomy using stentriever devices in patients with significant WMH. We hypothesized that WMH volume will not affect the hemorrhagic and clinical outcome in patients with acute ischemic stroke undergoing thrombectomy using new-generation devices...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#6
REVIEW
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28752508/safety-and-effectiveness-of-intravenous-thrombolysis-for-acute-ischemic-stroke-outside-the-coverage-of-national-health-insurance-in-taiwan
#7
Yu-Hsiang Su, Chih-Hung Chen, Huey-Juan Lin, Yu-Wei Chen, Mei-Chiun Tseng, Han-Chieh Hsieh, Chih-Hung Chen, Sheng-Feng Sung
PURPOSE: Only a small percentage of ischemic stroke patients were treated with intravenous thrombolysis in Taiwan, partly because of the narrow reimbursement criteria of the National Health Insurance (NHI). We aimed to assess the safety and effectiveness of intravenous thrombolysis not covered by the NHI. METHODS: This is a retrospective analysis of register data from four hospitals. All patients who received intravenous tissue plasminogen activator and fulfilled the American Heart Association/American Stroke Association (AHA/ASA) thrombolysis guidelines between January 2007 and June 2012 were distinguished into two groups: those in accordance (reimbursement group) and those not in accordance (non-reimbursement group) with the NHI reimbursement criteria...
March 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28739832/influence-of-renal-impairment-on-outcome-for-thrombolysis-treated-acute-ischemic-stroke-enchanted-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-post-hoc-analysis
#8
Susan J Carr, Xia Wang, Veronica V Olavarria, Pablo M Lavados, Jorge A Rodriguez, Jong S Kim, Tsong-Hai Lee, Richard I Lindley, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND AND PURPOSE: Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28720659/microbleeds-cerebral-hemorrhage-and-functional-outcome-after-stroke-thrombolysis-individual-patient-data-meta-analysis
#9
Andreas Charidimou, Guillaume Turc, Catherine Oppenheim, Shenqiang Yan, Jan F Scheitz, Hebun Erdur, Pascal P Klinger-Gratz, Marwan El-Koussy, Wakoh Takahashi, Yusuke Moriya, Duncan Wilson, Chelsea S Kidwell, Jeffrey L Saver, Asma Sallem, Solene Moulin, Myriam Edjlali-Goujon, Vincent Thijs, Zoe Fox, Ashkan Shoamanesh, Gregory W Albers, Heinrich P Mattle, Oscar R Benavente, H Rolf Jäger, Gareth Ambler, Junya Aoki, Jean-Claude Baron, Kazumi Kimura, Wataru Kakuda, Shunya Takizawa, Simon Jung, Christian H Nolte, Min Lou, Charlotte Cordonnier, David J Werring
BACKGROUND AND PURPOSE: We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. METHODS: We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator...
July 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28679847/safety-outcomes-after-thrombolysis-for-acute-ischemic-stroke-in-patients-with-recent-stroke
#10
MULTICENTER STUDY
Alexander E Merkler, Setareh Salehi Omran, Gino Gialdini, Michael P Lerario, Shadi Yaghi, Mitchell S V Elkind, Babak B Navi
BACKGROUND AND PURPOSE: It is uncertain whether previous ischemic stroke within 3 months of receiving intravenous thrombolysis (tPA [tissue-type plasminogen activator]) for acute ischemic stroke (AIS) is associated with an increased risk of adverse outcomes. METHODS: Using administrative claims data, we identified adults with AIS who received intravenous tPA at California, New York, and Florida hospitals from 2005 to 2013. Our primary outcome was intracerebral hemorrhage, and our secondary outcomes were unfavorable discharge disposition and inpatient mortality...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28596196/effect-of-retrievable-stent-size-on-endovascular-treatment-of-acute-ischemic-stroke-a-multicenter-study
#11
D Yang, Y Hao, W Zi, H Wang, D Zheng, H Li, M Tu, Y Wan, P Jin, G Xiao, Y Xiong, G Xu, X Liu
BACKGROUND AND PURPOSE: In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes. MATERIALS AND METHODS: Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device...
August 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28546325/reciprocal-interaction-of-24-hour-blood-pressure-variability-and-systolic-blood-pressure-on-outcome-in-stroke-thrombolysis
#12
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28494694/antagonizing-dabigatran-by-idarucizumab-in-cases-of-ischemic-stroke-or-intracranial-hemorrhage-in-germany-a-national-case-collection
#13
Pawel Kermer, Christoph C Eschenfelder, Hans-Christoph Diener, Martin Grond, Yasser Abdalla, Katharina Althaus, Jörg Berrouschot, Hakan Cangür, Michael Daffertshofer, Sebastian Edelbusch, Klaus Gröschel, Claus G Haase, Andreas Harloff, Valentin Held, Andreas Kauert, Peter Kraft, Arne Lenz, Wolfgang Müllges, Mark Obermann, Someieh Partowi, Jan Purrucker, Peter A Ringleb, Joachim Röther, Raluca Rossi, Niklas Schäfer, Andreas Schneider, Ramona Schuppner, Rüdiger J Seitz, Kristina Szabo, Robert Wruck
Background Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran that reverses its anticoagulant effects within minutes. It may exhibit the potential for patients under dabigatran therapy suffering ischemic stroke to regain eligibility for thrombolysis with rt-PA and may inhibit lesion growth in patients with intracerebral hemorrhage on dabigatran. Aims To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of ischemic stroke or intracranial hemorrhage...
June 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28471607/patient-outcomes-with-stent-retriever-thrombectomy-for-anterior-circulation-stroke-a-meta-analysis-and-review-of-the-literature
#14
Rotem Sivan-Hoffmann, Benjamin Gory, Muriel Rabilloud, Dorin N Gherasim, Xavier Armoiry, Roberto Riva, Paul-Emile Labeyrie, Udi Gonike-Sadeh, Islam Eldesouky, Francis Turjman
Mechanical thrombectomy with stent retrievers is now the reference therapy for acute ischemic stroke (AIS) in the anterior circulation in association with thrombolysis. We conducted an extensive systematic review and meta-analysis to evaluate the clinical and angiographic outcomes of stent-retriever thrombectomy in patients with acute anterior circulation stroke. Available literature published to date on observational studies and three randomized trials (MR CLEAN, ESCAPE, and EXTEND-IA) involving the stent-retriever device were reviewed...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#15
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28412317/medical-treatment-for-spontaneous-anticoagulation-related-intracerebral-hemorrhage-in-the-netherlands
#16
Laura J de Schipper, M Irem Baharoglu, Yvo B W E M Roos, Frank de Beer
BACKGROUND: Spontaneous anticoagulation-related intracerebral hemorrhage accounts for up to a quarter of spontaneous intracerebral hemorrhage cases and is associated with higher hematoma volume and a worse outcome. Guidelines recommend rapid anticoagulant reversal but mode and timing are not specified and optimal strategy is uncertain. Variability in everyday practice is unknown. METHODS: An invitation to a web-based survey was sent to 85 Dutch stroke neurologists in different hospitals, with questions about importance, timing, and medical management of spontaneous anticoagulation-related intracerebral hemorrhage...
July 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28356003/young-stroke-patients-treated-with-intravenous-thrombolysis-have-a-more-favorable-outcome-and-mortality-compared-with-older-patients
#17
Jijun Shi, Yongjun Cao, Shoujiang You, Zhichao Huang, Xia Zhang, Huihui Liu, Chun-Feng Liu
BACKGROUND: Previous clinical studies suggest that intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator benefits stroke patients, but the efficacy of IVT in young stroke patients is not well-studied in China. OBJECTIVE: We compared the safety and efficacy of IVT with recombinant tissue plasminogen activator between Chinese young stroke patients (18-50 years old) and older patients (51-80 years old). METHODS: We analyzed data from the Soochow Stroke Registry for 373 stroke patients (18-50 years, n=74 vs...
March 27, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28262403/clinical-predictors-for-favorable-outcomes-from-endovascular-recanalization-in-wake-up-stroke
#18
Sang Min Sung, Tae Hong Lee, Han Jin Cho, Gi Yong Cho, Dae Soo Jung, Jae Il Lee, Jun Kyeung Ko, Samuel Yip
BACKGROUND AND PURPOSE: Patients who have acute stroke symptoms present on awakening are ineligible for standard intravenous thrombolysis due to the unclear onset time of symptoms. Some of these wake-up stroke (WUS) patients may benefit from endovascular recanalization. This study aimed to evaluate clinical predictors of outcomes from endovascular recanalization in WUS patients. METHODS: Forty-one WUS patients with internal carotid (ICA) or middle cerebral artery (MCA) occlusion treated with endovascular recanalization were reviewed...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28156253/severe-carotid-stenosis-and-delay-of-reperfusion-in-endovascular-stroke-treatment-an-interventional-management-of-stroke-iii-study
#19
Steven L Gogela, Yair M Gozal, Bin Zhang, Thomas A Tomsick, Andrew J Ringer, Joseph P Broderick, Pooja Khatri, Todd A Abruzzo
OBJECTIVE The impact of extracranial carotid stenosis on interventional revascularization of acute anterior circulation stroke is unknown. The authors examined the effects of high-grade carotid stenosis on the results of endovascular treatment of patients in the Interventional Management of Stroke (IMS)-III trial. METHODS The 278 patients in the endovascular arm of the IMS-III trial were categorized according to the degree of carotid stenosis as determined by angiography. In comparing patients with severe stenosis or occlusion (≥ 70%) to those without severe stenosis (< 70%), the authors evaluated the time to endovascular reperfusion, modified Thrombolysis in Cerebrovascular Infarction (mTICI) scores, 24-hour mean infarct volumes, symptomatic intracerebral hemorrhage rates, and modified Rankin Scale (mRS) scores at 90 days...
February 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28130468/leukoaraiosis-intracerebral-hemorrhage-and-functional-outcome-after-acute-stroke-thrombolysis
#20
REVIEW
Kannikar Kongbunkiat, Duncan Wilson, Narongrit Kasemsap, Somsak Tiamkao, Fatima Jichi, Vanessa Palumbo, Michael D Hill, Alastair M Buchan, Simon Jung, Heinrich P Mattle, Nils Henninger, David J Werring
OBJECTIVE: To perform a systematic review and pooled meta-analysis of published studies to assess whether the presence of leukoaraiosis on neuroimaging before treatment with thrombolysis (IV or intra-arterial) is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) or poor functional outcome. METHODS: We included studies of patients with acute ischemic stroke, treated with IV or intra-arterial thrombolysis, which assessed functional outcome (3-month modified Rankin Scale [mRS]) or sICH in relation to leukoaraiosis on pretreatment neuroimaging (CT or MRI)...
February 14, 2017: Neurology
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