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Intravenous thrombolysis

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https://www.readbyqxmd.com/read/29769590/low-factor-xiii-levels-after-intravenous-thrombolysis-predict-short-term-mortality-in-ischemic-stroke-patients
#1
Edina Gabriella Székely, Katalin Réka Czuriga-Kovács, Zsuzsanna Bereczky, Éva Katona, Zoltán András Mezei, Attila Nagy, Noémi Klára Tóth, Ervin Berényi, László Muszbek, László Csiba, Zsuzsa Bagoly
In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29768962/successful-thrombectomy-in-endocarditis-related-stroke-case-report-and-review-of-the-literature
#2
Manuel Bolognese, Alexander von Hessling, Martin Müller
Neurological complications of infective endocarditis are frequent, especially ischaemic strokes. As intravenous thrombolysis in infective endocarditis-related ischaemic stroke has a controversial benefit/risk ratio, alternative treatment regimens have to be considered. We present the case of a young patient with septic embolism of the middle cerebral artery who was successfully treated with mechanical thrombectomy, and give a short review of the existing literature.
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29766770/mri-guided-thrombolysis-for-stroke-with-unknown-time-of-onset
#3
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/29765396/acute-in-stent-thrombosis-after-carotid-angioplasty-and-stenting-a-case-report-and-literature-review
#4
Wei Hu, Li Wang, GuoPing Wang
Background: Based on the results of a recent randomized controlled trial, carotid artery stenting (CAS) was regarded as a relatively safe, less invasive treatment of internal carotid artery stenosis. However, cerebral thromboembolic events are the most common complications of CAS. Especially acute stent thrombosis following CAS will be fatal without prompt diagnosis and revascularization. Case Report: We report a case of acute stent thrombosis in whom carotid revascularization was performed successfully via arterial thrombolysis and balloon postdilation...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764930/closure-of-large-bore-9-f-arterial-puncture-sites-with-the-angioseal-sts-device-in-acute-stroke-patients-after-intravenous-recombinant-tissue-plasminogen-activator-rt-pa
#5
Hendrik Janssen, Monika Killer-Oberpfalzer, Ruediger Lange
PURPOSE: This retrospective analysis was performed to evaluate whether large bore 9 F puncture sites can be safely closed with the 8 F AngioSeal STS device after endovascular stroke procedures in patients who did or did not receive recombinant tissue plasminogen activator (rt-PA). METHODS: Out of 161 consecutive endovascular stroke procedures we identified 72 patients who met the inclusion criteria, of whom 46 received rt-PA before the endovascular procedure and 26 did not...
May 15, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29748424/intravenous-recombinant-tissue-type-plasminogen-activator-influence-on-outcome-in-anterior-circulation-ischemic-stroke-treated-by-mechanical-thrombectomy
#6
Marc Ferrigno, Nicolas Bricout, Didier Leys, Laurent Estrade, Charlotte Cordonnier, Thomas Personnic, Maeva Kyheng, Hilde Henon
BACKGROUND AND PURPOSE: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) improves functional outcome in patients with ischemic stroke related to proximal-vessel occlusion in the anterior circulation. Whether MT alone is as effective as IVT/MT remains controversial. We aimed at evaluating the influence of IVT in patients with large anterior circulation artery occlusion treated with MT. METHODS: We did a prospective observational cohort study in patients with stroke related to large anterior circulation artery occlusion treated by MT who were admitted to Lille University Hospital, Lille, France...
May 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29746644/relationships-between-selective-neuronal-loss-and-microglial-activation-after-ischaemic-stroke-in-man
#7
Rhiannon S Morris, P Simon Jones, Josef A Alawneh, Young T Hong, Tim D Fryer, Franklin I Aigbirhio, Elizabeth A Warburton, Jean-Claude Baron
Modern ischaemic stroke management involves intravenous thrombolysis followed by mechanical thrombectomy, which allows markedly higher rates of recanalization and penumbral salvage than thrombolysis alone. However, <50% of treated patients eventually enjoy independent life. It is therefore important to identify complementary therapeutic targets. In rodent models, the salvaged penumbra is consistently affected by selective neuronal loss, which may hinder recovery by interfering with plastic processes, as well as by microglial activation, which may exacerbate neuronal death...
May 9, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29744447/in-vivo-evaluation-of-urokinase-loaded-hollow-nanogels-for-sonothrombolysis-on-suture-embolization-induced-acute-ischemic-stroke-rat-model
#8
Yuming Teng, Haiqiang Jin, Ding Nan, Mengnan Li, Chenghe Fan, Yuanyuan Liu, Pu Lv, Wei Cui, Yongan Sun, Hongjun Hao, Xiaozhong Qu, Zhenzhong Yang, Yining Huang
The urokinase-type plasminogen activator (uPA) loaded hollow nanogels (nUK) were synthesized by a one-step reaction of glycol chitosan and aldehyde capped poly (ethylene oxide). The resultant formulation is sensitive to diagnostic ultrasound (US) of 2 MHz. Herein, we evaluated the in vivo sonothrombolysis performance of the nUK on acute ischemic stroke rat model which was established by suture embolization of middle cerebral artery (MCA). Via intravenous (i.v.) administration, the experimental data prove a controlled release of the therapeutic protein around the clots under ultrasound stimulation, leading to enhanced thrombolysis efficiency of the nUK, evidenced from smaller infarct volume and better clinical scores when compared to the i...
March 2018: Bioactive Materials
https://www.readbyqxmd.com/read/29743763/impact-of-stroke-code-rapid-response-team-an-attempt-to-improve-intravenous-thrombolysis-rate-and-to-shorten-door-to-needle-time-in-acute-ischemic-stroke
#9
Sushma K Gurav, Kapil G Zirpe, R S Wadia, Avinash Naniwadekar, Prajakta U Pote, Amit Tungenwar, Abhijeet M Deshmukh, Srikanta Mohopatra, Balakrishna Nimavat, Prasad Surywanshi
Objective: "Stroke code" (SC) implementation in hospitals can improve the rate of thrombolysis and the timeline in care of stroke patient. Materials and Methods: A prospective data of patients treated for acute ischemic stroke (AIS) after implementation of "SC" (post-SC era) were analyzed (2015-2016) and compared with the retrospective data of patients treated in the "pre-SC era." Parameters such as symptom-to-door, door-to-physician, door-to-imaging, door-to-needle (DTN), and symptom-to-needle time were calculated...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29736735/current-endovascular-approach-to-the-management-of-acute-ischemic-stroke
#10
REVIEW
Rakesh Khatri, Anantha R Vellipuram, Alberto Maud, Salvador Cruz-Flores, Gustavo J Rodriguez
PURPOSE OF REVIEW: The review provides an overview of current endovascular management of patients with acute ischemic stroke in the light of recent landmark trials proving unequivocal benefit of the intervention. RECENT FINDINGS: Several randomized trials looking at selective groups of patients presenting after an acute ischemic stroke due to large vessel occlusion in the anterior circulation demonstrated an overwhelming benefit of the endovascular treatment compared to intravenous thrombolysis, leading to expedited changes in the American Heart Association/American Stroke Association guidelines...
May 7, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29729542/safety-and-cost-effectiveness-thrombolysis-by-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch-for-wake-up-stroke
#11
REVIEW
Tong Sun, Zhuan Xu, Shan-Shan Diao, Lu-Lu Zhang, Qi Fang, Xiu-Ying Cai, Yan Kong
Wake-up stroke, defined as patients who wake up with stroke symptoms which were not present prior to falling asleep, accounted for 14%-25% of acute ischemic stroke. Due to the unknown time of symptom onset, wake-up stoke was not in including criteria of intravenous thrombolysis. Several large randomized stroke trials using diffusion-weighted imaging(DWI)and fluid attenuated inversion recovery(FLAIR)mismatch patient selection may identify a subset of patients with wake-up stroke that can safely and effectively benefit from intravenous thrombolysis...
April 23, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29728903/tenecteplase-versus-alteplase-in-acute-ischemic-stroke-systematic-review-and-meta-analysis
#12
A Thelengana, Divya M Radhakrishnan, Manya Prasad, Amit Kumar, Kameshwar Prasad
Tenecteplase is a product of genetic modification of recombinant tissue plasminogen activator with superior pharmacodynamic and pharmacokinetic properties. This meta-analysis was to determine whether intravenous thrombolysis with tenecteplase in patients with acute ischemic stroke has better efficacy and safety outcomes than with intravenous alteplase. PubMed, Cochrane Central Register of Controlled Trials, WHO International clinical trials registry platform (ICTRP), Australian New Zealand Clinical Trials Registry (ANZCTR), EU Clinical Trials Register (EU-CTR) and ClinicalTrials...
May 4, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29725176/clinical-outcomes-of-endovascular-thrombectomy-in-tissue-plasminogen-activator-versus-non-tissue-plasminogen-activator-patients-at-primary-stroke-care-centers
#13
Gregory Imbarrato, Joshua Bentley, Ajeet Gordhan
Background: The effect of intravenous tissue plasminogen activator (IV tPA) administration before endovascular intervention as compared to without at thrombectomy-capable low-volume centers on procedural aspects and patient outcomes has not been investigated. Methods: Retrospective chart review was performed in all consecutive large vessel cerebrovascular accident patients treated with endovascular therapy at two select rural primary stroke centers between 2011 and 2015...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29724190/association-between-different-acute-stroke-therapies-and-development-of-post-stroke-seizures
#14
Jillian Naylor, Arthur Thevathasan, Leonid Churilov, Ruibing Guo, Yunyun Xiong, Miriam Koome, Ziyi Chen, Ziyuan Chen, Xinfeng Liu, Patrick Kwan, Bruce C V Campbell
BACKGROUND: Epilepsy is a major complication of stroke. We aimed to establish whether there is an association between intravenous thrombolysis, intra-arterial thrombolysis and post stroke seizure (PSS) development. Improved understanding of the relationship between reperfusion therapies and seizure development may improve post-stroke monitoring and follow-up. METHODS: This was a retrospective, multicentre cohort study conducted at the Royal Melbourne Hospital and Jingling Hospital Nanjing...
May 3, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29719551/importance-of-reperfusion-status-after-intra-arterial-thrombectomy-for-prediction-of-outcome-in-anterior-circulation-large-vessel-stroke
#15
Luuk Dekker, Victor J Geraedts, Hajo Hund, Suzanne C Cannegieter, Raul G Nogueira, Mayank Goyal, Ido R van den Wijngaard
Background: Reperfusion status after intra-arterial thrombectomy (IAT) is a critical predictor of functional outcome after acute ischemic stroke. However, most prognostic models have not included a detailed assessment of reperfusion status after IAT. Objective: The aim of this work was to assess the association between successful reperfusion and clinical outcome. Methods: Clinical, radiological, and procedural variables of patients treated with IAT were extracted from our prospective stroke registry...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29718909/impact-of-smoking-on-stroke-outcome-after-endovascular-treatment
#16
Rascha von Martial, Jan Gralla, Pasquale Mordasini, Marwan El Koussy, Sebastian Bellwald, Bastian Volbers, Rebekka Kurmann, Simon Jung, Urs Fischer, Marcel Arnold, Hakan Sarikaya
BACKGROUND: Recent studies suggest a paradoxical association between smoking status and clinical outcome after intravenous thrombolysis (IVT). Little is known about relationship between smoking and stroke outcome after endovascular treatment (EVT). METHODS: We analyzed data of all stroke patients treated with EVT at the tertiary stroke centre of Berne between January 2005 and December 2015. Using uni- and multivariate modeling, we assessed whether smoking was independently associated with excellent clinical outcome (modified Rankin Scale (mRS) 0-1) and mortality at 3 months...
2018: PloS One
https://www.readbyqxmd.com/read/29718846/high-risk-pulmonary-embolism-assessed-by-transthoracic-echocardiography-a-case-report
#17
Jiahong Wu, Jing Zhang, Fangfang Yang, Chuanbao Li, Mei Ni
RATIONALE: Acute pulmonary embolism (APE) as a life-threatening illness may present with a wide range of manifestations. APE was diagnosed using computed tomographic pulmonary angiography (CTPA); however, transthoracic echocardiography (TTE) can reveal hemodynamic status. Early thrombolysis is the most effective therapy for the treatment of massive pulmonary embolism. PATIENTS CONCERNS: Herein, we report a case of high-risk APE with a wide range of manifestations, including chest pain, dyspnea, low-blood pressure, and syncope...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29715283/leukoaraiosis-and-risk-of-intracranial-hemorrhage-and-outcome-after-stroke-thrombolysis
#18
Chun-Ming Yang, Chien-Ling Hung, Hui-Chen Su, Huey-Juan Lin, Chih-Hung Chen, Chou-Ching Lin, Han-Hwa Hu, Sheng-Hsiang Lin, Pi-Shan Sung
BACKGROUND: The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. METHODS: Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29705803/lipid-lowering-pretreatment-and-outcome-following-intravenous-thrombolysis-for-acute-ischaemic-stroke-a-post-hoc-analysis-of-the-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-trial
#19
Jatinder S Minhas, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Geoffrey A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Sheila Cristina Ouriques Martins, Verónica V Olavarría, Jeyaraj D Pandian, Octávio Marques Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND: Debate exists as to whether statin pretreatment confers an increased risk of 90-day mortality and symptomatic intracranial haemorrhage (sICH) in acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis. We assessed the effects of undifferentiated lipid-lowering pretreatment on outcomes and interaction with low-dose versus standard-dose alteplase in a post hoc subgroup -analysis of the Enhanced Control of Hypertension and Thrombolysis Stroke Study. METHODS: In all, 3,284 thrombolysis-eligible AIS patients (mean age 66...
April 27, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29705773/direct-mechanical-thrombectomy-in-tpa-ineligible-and-eligible-patients-versus-the-bridging-approach-a-meta-analysis
#20
Johannes Kaesmacher, Pasquale Mordasini, Marcel Arnold, Elena López-Cancio, Neus Cerdá, Tobias Boeckh-Behrens, Justus F Kleine, Mayank Goyal, Michael D Hill, Vitor Mendes Pereira, Jeffrey L Saver, Jan Gralla, Urs Fischer
BACKGROUND: Whether pretreatment with intravenous thrombolysis prior to mechanical thrombectomy (IVT+MTE) adds additional benefit over direct mechanical thrombectomy (dMTE) in patients with large vessel occlusions (LVO) is a matter of debate. METHODS: This study-level meta-analysis was presented in accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled effect sizes were calculated using the inverse variance heterogeneity model and displayed as summary Odds Ratio (sOR) and corresponding 95% confidence interval (95% CI)...
April 28, 2018: Journal of Neurointerventional Surgery
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