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Intravenous thrombolysis

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https://www.readbyqxmd.com/read/28624140/minor-nonintracranial-hemorrhage-and-poor-prognosis-among-stroke-patients-undergoing-intravenous-thrombolysis
#1
Xiaoming Qin, Songyao Zhao, Liujie Yin, Hailing Dou, Jie Chen, Yifan Wang, Mingzhe Li, Ruifang Chen, Gaiqing Yang, Xin Liu, Runqing Wang, Xinzhou Jia, Shufang Bu, Dongpu Ma, Baoyu Wang, Shize Li
BACKGROUND: Whether nonintracranial hemorrhage (NICH) associated with intravenous thrombolysis (IVT) is a predictor of intracranial hemorrhage (ICH) and poor prognosis is ambiguous. We sought to analyze the rate of NICH and the relationship between NICH and poor outcome in the ischemic stroke population undergoing IVT. METHODS: This is a single-center, hospital-based prospective study. All ischemic stroke patients undergoing IVT between December 2015 and November 2016 were included...
June 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28621151/case-report-and-literature-review-on-contrast-induced-encephalopathy
#2
Mardi Hamra, Yasir Bakhit, Mahboob Khan, Roger Moore
Contrast-induced encephalopathy (CIE) is a rare neurological complication following the administration of injectable intravascular contrast media. Patients with CIE present a wide spectrum of symptoms such as headache, transient cortical blindness, seizure and focal neurological deficits. The diagnosis of CIE requires a high index of suspicion. Its early recognition is of paramount importance in instituting the appropriate supportive treatment in the form of intravenous fluids and also in avoiding unnecessary potentially harmful treatment such as intravenous thrombolysis for suspected ischemic stroke...
June 16, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28619989/low-versus-standard-dose-alteplase-in-patients-on-prior-antiplatelet-therapy-the-enchanted-trial-enhanced-control-of-hypertension-and-thrombolysis-stroke-study
#3
Thompson G Robinson, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Andrew M Demchuk, Geoffery A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Richard I Lindley, Sheila C O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Thang H Nguyen, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Many patients receiving thrombolysis for acute ischemic stroke are on prior antiplatelet therapy (APT), which may increase symptomatic intracerebral hemorrhage risk. In a prespecified subgroup analysis, we report comparative effects of different doses of intravenous alteplase according to prior APT use among participants of the international multicenter ENCHANTED study (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: Among 3285 alteplase-treated patients (mean age, 66...
June 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28615907/successful-revascularization-of-acute-middle-cerebral-artery-occlusion-by-intravenous-thrombolysis-while-on-apixaban
#4
Vivek K Nambiar, T S Dhanya, Amrutha V Ajai
No abstract text is available yet for this article.
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#5
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28612911/short-term-efficacy-and-safety-of-three-different-antiplatelet-regimens-in-diabetic-patients-treated-with-primary-percutaneous-coronary-intervention-a-randomized-study
#6
Yang Liu, Hengliang Liu, Yibin Hao, Zhenxuan Hao, Guoying Geng, Wenjie Han, Qi Chen, Danli Wang, Lingzhi Liu, Kailong Jia, Yuxin Zhou
BACKGROUND: This study aimed to investigate the efficacy and safety of dual and triple antiplatelet therapy (DAPT and TAPT) in patients with diabetes and acute ST segment elevation myocardial infarction (D-STEMI), who had undergone primary percutaneous coronary intervention (PCI). METHODS: We designed a phase IV, single-center, randomized, double-blind, placebo-controlled study. The D-STEMI patients (N=258) were randomly divided into three groups. Control group A (85 patients), was treated with aspirin and clopidogrel; group B (87 patients) received aspirin, clopidogrel, and tirofiban; and group C (86 patients) was treated with aspirin, ticagrelor, and tirofiban...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28601259/validation-of-serial-alberta-stroke-program-early-ct-score-as-an-outcome-predictor-in-thrombolyzed-stroke-patients
#7
Wan-Yee Kong, Benjamin Y Q Tan, Nicholas J H Ngiam, Deborah Y C Tan, Christine H Yuan, Staffan Holmin, Tommy Andersson, Erik Lundström, Hock Luen Teoh, Bernard P L Chan, Rahul Rathakrishnan, Eric Y S Ting, Vijay K Sharma, Leonard L L Yeo
BACKGROUND: The Alberta Stroke Program Early CT Score (ASPECTS) on baseline imaging is an established predictor of functional outcome in anterior circulation acute ischemic stroke (AIS). We studied ASPECTS before intravenous thrombolysis (IVT) and at 24 hours to assess its prognostic value. METHODS: Data for consecutive anterior circulation AIS patients treated with IVT from 2006 to 2013 were extracted from a prospectively managed registry at our tertiary center...
June 7, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28596447/impact-of-thrombus-length-on-outcomes-after-intra-arterial-aspiration-thrombectomy-in-the-therapy-trial
#8
Albert J Yoo, Pooja Khatri, J Mocco, Osama O Zaidat, Rishi Gupta, Donald Frei, Demetrius Lopes, Harish Shownkeen, Olvert A Berkhemer, Denise Meyer, Susana S Hak, Sophia S Kuo, Hope Buell, Arani Bose, Siu Po Sit, Rüdiger von Kummer
BACKGROUND AND PURPOSE: Increasing thrombus length (TL) impedes recanalization after intravenous (IV) thrombolysis. We sought to determine whether the clinical benefit of aspiration thrombectomy relative to IV r-tPA (recombinant tissue-type plasminogen activator) may be greater at longer TL. METHODS: THERAPY was a randomized trial of aspiration thrombectomy plus IV r-tPA versus IV r-tPA alone in large-vessel stroke patients with prospective TL measurement ≥8 mm...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#9
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of acute cardiovascular mortality and long-term morbidity. Right ventricular (RV) dysfunction is the key determinant of prognosis in the acute phase of PE, and residual RV dysfunction is associated with the development of post-PE functional impairment, chronic thromboembolic disease, and higher costs of treatment over the long term. Patients with clinically overt RV failure, i.e. hemodynamic collapse at presentation (high-risk PE), necessitate immediate thrombolytic treatment to relieve the obstruction in the pulmonary circulation; surgical or catheter-directed removal of the thrombus can be an alternative option...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28592785/multidisciplinary-approach-to-decrease-in-hospital-delay-for-stroke-thrombolysis
#10
Sang-Beom Jeon, Seung Mok Ryoo, Deok Hee Lee, Sun U Kwon, Seongsoo Jang, Eun-Jae Lee, Sang Hun Lee, Jung Hee Han, Mi Jeong Yoon, Soo Jeong, Young-Uk Cho, Sungyang Jo, Seung-Bok Lim, Joong-Goo Kim, Han-Bin Lee, Seung Chai Jung, Kye Won Park, Min-Hwan Lee, Dong-Wha Kang, Dae Chul Suh, Jong S Kim
BACKGROUND AND PURPOSE: Decreasing the time delay for thrombolysis, including intravenous thrombolysis (IVT) with tissue plasminogen activator and intra-arterial thrombectomy (IAT), is critical for decreasing the morbidity and mortality of patients experiencing acute stroke. We aimed to decrease the in-hospital delay for both IVT and IAT through a multidisciplinary approach that is feasible 24 h/day. METHODS: We implemented the Stroke Alert Team (SAT) on May 2, 2016, which introduced hospital-initiated ambulance prenotification and reorganized in-hospital processes...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28589229/-stroke-in-children-and-adolescents
#11
REVIEW
S Meyer, M Poryo, M Flotats-Bastardas, D Ebrahimi-Fakhari, U Yilmaz
The occurrence of a stroke in children and adolescents constitutes a rare, critical event that is associated with substantial morbidity and mortality. In addition to the individual suffering for the young patient and the medical burden for the affected family, a stroke is also associated with high follow-up costs for the health system because of the necessary long-term rehabilitative treatment. Establishing an early and prompt diagnosis is of great therapeutic importance. Because of the rarity of the illness and the plethora of clinical manifestations, diagnosis is often delayed...
June 6, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28579600/incidence-management-and-short-term-outcome-of-stroke-in-a-general-population-of-1-4-million-japanese%C3%A3-shiga-stroke-registry
#12
Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Naomi Miyamatsu, Masaru Komori, Yoshihisa Sugimoto, Satoru Nagata, Katsuyuki Miura, Kazuhiko Nozaki
BACKGROUND: This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28579511/streamlining-workflow-for-endovascular-mechanical-thrombectomy-lessons-learned-from-a-comprehensive-stroke-center
#13
REVIEW
Hongjin Wang, Arthur Thevathasan, Richard Dowling, Steven Bush, Peter Mitchell, Bernard Yan
BACKGROUND: Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays...
June 1, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28579039/total-mismatch-of-diffusion-weighted-imaging-and-susceptibility-weighted-imaging-in-patients-with-acute-cerebral-ischemia
#14
Min-Gyu Park, Jeong A Yeom, Seung Kug Baik, Kyung-Pil Park
BACKGROUND AND PURPOSE: Multiple hypointense vessels (MHV) on susceptibility-weighted imaging (SWI) is associated with an increased oxygen demand in acute cerebral ischemia. Occasionally, some patients exhibit extensive MHV on SWI despite of negative diffusion-weighted imaging (DWI), which is a phenomenon called total mismatch DWI-SWI. We analyzed the clinical characteristics and imaging findings in patients with the total DWI-SWI mismatch. MATERIALS AND METHODS: We selected patients with total DWI-SWI mismatch who underwent MRI within 12hours from onset...
May 31, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28574595/influence-of-hospital-type-on-outcomes-of-individuals-aged-80-and-older-with-stroke-treated-using-intravenous-thrombolysis
#15
Francisco Purroy, Ana Vena, David Cánovas, Pere Cardona, Dolores Cocho, Elisa Cuadrado-Godia, Angel Chamorro, Antonio Dávalos, Moisés Garcés, Meritxell Gomis, Jerzy Krupinski, Ernest Palomeras, Marc Ribó, Jaume Roquer, Marta Rubiera, Jordi Sanahuja, Júlia Saura, Joaquín Serena, Xavier Ustrell, Martha Vargas, Ikram Benabdelhak, Sonia Abilleira, Miquel Gallofré
OBJECTIVES: The aim of the study was to confirm the safety and effectiveness of using intravenous thrombolysis (IVT) with individuals aged 80 and older in routine practice in different hospital settings. DESIGN: Observasional registry. SETTING: Prospective multicenter population-based registry of acute stroke patients treated with reperfusion therapies in Catalonia, Spain (Sistema Online d'Informació de l'Ictus Agut). PARTICIPANTS: Individuals treated only with IVT (N = 3,231; 1,189 (36...
June 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28558372/dosage-calculation-for-intravenous-thrombolysis-of-ischemic-stroke-to-weigh-or-to-estimate
#16
Andreas Ragoschke-Schumm, Asem Razouk, Martin Lesmeister, Stefan Helwig, Iris Q Grunwald, Klaus Fassbender
BACKGROUND: Estimation is a widely used method of assessing the weight of patients with acute stroke. Because the dosage of tissue plasminogen activator (tPA) is weight-dependent, errors in estimation lead to incorrect dosing. METHODS: We installed a ground-level scale in the computed tomography (CT) suite of our hospital and also integrated a scale into the CT table of our Mobile Stroke Unit in order to prospectively assess the differences between reported, estimated, and measured weights of acute stroke patients...
May 30, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28556351/thrive-score-predicts-clinical-and-radiological-outcome-after-endovascular-therapy-or-thrombolysis-in-patients-with-anterior-circulation-stroke-in-everyday-clinical-practice
#17
A Kastrup, F Brunner, H Hildebrandt, C Roth, M Winterhalter, C Gießing, P Papanagiotou
BACKGROUND AND PURPOSE: Based on the data of several trials the Totaled Health Risks in Vascular Events (THRIVE) score has been shown to predict outcome after either intravenous thrombolysis (IVT) or endovascular therapy (ET) in acute stroke patients. It is unknown whether the THRIVE score can also predict outcome in everyday clinical practice. Using our prospectively obtained stroke database the utility of the THRIVE score to predict clinical and radiological outcome in everyday clinical practice was analysed...
May 29, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28554177/high-prestroke-physical-activity-is-associated-with-reduced-infarct-growth-in-acute-ischemic-stroke-patients-treated-with-intravenous-tpa-and-randomized-to-remote-ischemic-perconditioning
#18
Rolf A Blauenfeldt, Kristina D Hougaard, Kim Mouridsen, Grethe Andersen
BACKGROUND: A high prestroke physical activity (PA) level is associated with reduced stroke rate, stroke mortality, better functional outcome, and possible neuroprotective abilities. The aim of the present study was to examine the possible neuroprotective effect of prestroke PA on 24-h cerebral infarct growth in a cohort of acute ischemic stroke patients treated with intravenous tPA and randomized to remote ischemic perconditioning. METHODS: In this predefined subanalysis, data from a randomized clinical trial investigating the effect of remote ischemic perconditioning (RIPerC) on AIS was used...
May 30, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28551292/clinical-outcomes-of-patients-with-acute-basilar-artery-occlusion-in-brazil-an-observational-study
#19
Francisco Antunes Dias, Frederico Fernandes Alessio-Alves, Luis Henrique Castro-Afonso, Pedro Telles Cougo, Clara Monteiro Antunes Barreira, Millene Rodrigues Camilo, Guilherme Seizem Nakiri, Daniel Giansante Abud, Octavio Marques Pontes-Neto
BACKGROUND: Intravenous thrombolysis (IVT) and endovascular therapy (EVT) were proven safe and effective for anterior circulation proximal occlusions. However, the most appropriate recanalization strategy in patients with acute basilar artery occlusion (BAO) is still controversial. This study aimed to assess outcomes of patients with BAO at an academic stroke center in Brazil. METHODS: This is a retrospective analysis of consecutive patients with BAO from a prospective stroke registry at Ribeirão Preto Medical School...
May 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28550481/antiplatelet-pretreatment-and-outcomes-in-intravenous-thrombolysis-for-stroke-a-systematic-review-and-meta-analysis
#20
Georgios Tsivgoulis, Aristeidis H Katsanos, Ramin Zand, Vijay K Sharma, Martin Köhrmann, Sotirios Giannopoulos, Efthymios Dardiotis, Anne W Alexandrov, Panayiotis D Mitsias, Peter D Schellinger, Andrei V Alexandrov
Since there are contradictory data regarding the association of antiplatelet pretreatment (AP) with safety and efficacy outcomes of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS), we conducted a systematic review and meta-analysis of available randomized-controlled clinical trials (RCTs) to investigate the association of AP with outcomes of AIS patients treated with intravenous alteplase. The outcome events of interest included symptomatic intracranial hemorrhage (sICH), fatal ICH, complete recanalization (CR), 3-month favorable functional outcome (FFO, mRS score 0-1), 3-month functional independence (FI, mRS score 0-2), and mortality...
June 2017: Journal of Neurology
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