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Intravenous thrombolysis

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https://www.readbyqxmd.com/read/28319471/early-secondary-prevention-after-initially-ineffective-revascularization-treatments-for-acute-ischemic-stroke-due-to-tandem-occlusion
#1
Stefano Forlivesi, Elia Pancheri, Giuseppe Moretto, Paolo Bovi, Manuel Cappellari
The most effective treatment of patients with stroke due to tandem occlusion is still unclear. We report the case of a man with stroke due to tandem internal carotid artery/middle cerebral artery occlusion, who underwent initially ineffective intravenous thrombolysis (IVT) and endovascular treatment. Early anticoagulation with apixaban was started after 48 h of IVT, given a newly diagnosed nonvalvular atrial fibrillation. Spontaneous partial recanalization of the cervical internal carotid artery was noted, and carotid endarterectomy was performed 72 h after IVT and 8 h after the last dose of apixaban...
March 17, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28319240/two-paradigms-for-endovascular-thrombectomy-after-intravenous-thrombolysis-for-acute-ischemic-stroke
#2
Gaspard Gerschenfeld, Ioan-Paul Muresan, Raphael Blanc, Michael Obadia, Marie Abrivard, Michel Piotin, Sonia Alamowitch
Importance: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) is recommended to treat acute ischemic stroke (AIS) with a large vessel occlusion (LVO). Most hospitals do not have on-site MT facilities, and most patients need to be transferred secondarily after IVT (drip and ship), which may have an effect on the neurologic outcome. Objective: To compare the functional independence at 3 months between patients treated under the drip-and-ship paradigm and those treated on site (mothership)...
March 20, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28315960/intravenous-thrombolysis-for-ischemic-stroke-in-the-golden-hour-propensity-matched-analysis-from-the-sits-east-registry
#3
Georgios Tsivgoulis, Aristeidis H Katsanos, Pavla Kadlecová, Anna Czlonkowska, Adam Kobayashi, Miroslav Brozman, Viktor Švigelj, Laszlo Csiba, Klara Fekete, Janika Kõrv, Vida Demarin, Aleksandras Vilionskis, Dalius Jatuzis, Yakup Krespi, Chrissoula Liantinioti, Sotirios Giannopoulos, Robert Mikulik
As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset ("golden hour"), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(-)] the "golden hour" by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of ≥10 points on NIHSS-score or a total NIHSS-score of ≤3 at 2 and 24 h, respectively...
March 18, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28314516/impact-of-an-intrahospital-mobile-thrombolysis-team-on-3-month-clinical-outcomes-in-patients-benefiting-from-intravenous-thrombolysis-for-acute-ischemic-stroke
#4
B Hebant, A Triquenot-Bagan, E Guegan-Massardier, O Ozkul-Wermester, L Grangeon, D Maltête
INTRODUCTION/OBJECTIVE: The benefits of thrombolysis in patients presenting with acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to evaluate the clinical benefit, after 3 months, of an intrahospital mobile thrombolysis team (MTT) for thrombolysis in IS. PATIENTS AND METHODS: A total of 95 consecutive patients treated with IV tPA for acute IS at the neurology department of Rouen University Hospital between 1 January and 31 December 2015 were retrospectively identified...
March 14, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#5
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28302608/ipsilateral-prominent-thalamostriate-vein-on-susceptibility-weighted-imaging-predicts-poor-outcome-after-intravenous-thrombolysis-in-acute-ischemic-stroke
#6
X Zhang, S Zhang, Q Chen, W Ding, B C V Campbell, M Lou
BACKGROUND AND PURPOSE: The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis. MATERIALS AND METHODS: We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28291782/obesity-paradox-in-stroke-myth-or-reality-a-systematic-review
#7
Lisa Oesch, Turgut Tatlisumak, Marcel Arnold, Hakan Sarikaya
BACKGROUND AND PURPOSE: Both stroke and obesity show an increasing incidence worldwide. While obesity is an established risk factor for stroke, its influence on outcome in ischemic stroke is less clear. Many studies suggest a better prognosis in obese patients after stroke ("obesity paradox"). This review aims at assessing the clinical outcomes of obese patients after stroke by performing a systematic literature search. METHODS: The reviewers searched MEDLINE from inception to December 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28283607/individual-and-system-contributions-to-race-and-sex-disparities-in-thrombolysis-use-for-stroke-patients-in-the-united-states
#8
Roland Faigle, Victor C Urrutia, Lisa A Cooper, Rebecca F Gottesman
BACKGROUND AND PURPOSE: Intravenous thrombolysis (IVT) is underutilized in ethnic minorities and women. To disentangle individual and system-based factors determining disparities in IVT use, we investigated race/sex differences in IVT utilization among hospitals serving varying proportions of minority patients. METHODS: Ischemic stroke admissions were identified from the Nationwide Inpatient Sample between 2007 and 2011. Hospitals were categorized based on the percentage of minority patients admitted with stroke (<25% minority patients [white hospitals], 25% to 50% minority patients [mixed hospitals], or >50% minority patients [minority hospitals])...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28277464/clot-imaging-in-large-vessel-occlusion-strokes
#9
Johnny H Wong, Michael P Marks
Advances in mechanical thrombectomy techniques have resulted in improved, recanalization and functional outcomes in acute stroke, as demonstrated in recent, randomized trials comparing mechanical thrombectomy with thrombolysis. In conjunction with the technological advancements in thrombectomy devices, there has been better appreciation of stricter patient selection criteria for endovascular therapy based on pre-procedural imaging, including clot location, infarct volume, and penumbral territory at risk. Pre-procedural imaging performed to assess suitability for endovascular therapy commonly provides information on clot characteristics, such as clot location, length, density, and susceptibility, which can influence and may predict the efficacy of intravenous and endovascular treatments...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28275651/platelet-microparticles-a-biomarker-for-recanalization-in-rtpa-treated-ischemic-stroke-patients
#10
Andrew Bivard, Lisa F Lincz, Jane Maquire, Mark Parsons, Christopher Levi
OBJECTIVES: Identification of a biomarker for acute recanalization could have significant clinical impact. METHODS: We prospectively collected baseline, 24-h, and 90-day clinical and imaging data from consecutive ischemic stroke patients who fulfilled standard clinical eligibility criteria for treatment with intravenous recombinant tissue plasminogen activator (rtPA). Computed tomography angiography was acquired at 24 h and assessed using the thrombolysis is myocardial infarction (TIMI) scale with a score of 2b/3 indicating recanalization...
March 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28266892/inflammatory-and-metalloproteinases-profiles-predict-three-month-poor-outcomes-in-ischemic-stroke-treated-with-thrombolysis
#11
Anna Maria Gori, Betti Giusti, Benedetta Piccardi, Patrizia Nencini, Vanessa Palumbo, Mascia Nesi, Antonia Nucera, Giovanni Pracucci, Paolina Tonelli, Eleonora Innocenti, Alice Sereni, Elena Sticchi, Danilo Toni, Paolo Bovi, Mario Guidotti, Maria Rosaria Tola, Domenico Consoli, Giuseppe Micieli, Rossana Tassi, Giovanni Orlandi, Maria Sessa, Francesco Perini, Maria Luisa Delodovici, Maria Luisa Zedde, Francesca Massaro, Rosanna Abbate, Domenico Inzitari
Inflammatory mediators and metalloproteinases are altered in acute ischemic stroke (AIS) and play a detrimental effect on clinical severity and hemorrhagic transformation of the ischemic brain lesion. Using data from the Italian multicenter observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) Study, we evaluated the effect of inflammatory and metalloproteinases profiles on three-month functional outcome, hemorrhagic transformation and mortality in 327 patients with AIS treated with intravenous thrombolys in according to SITS-MOST (Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy) criteria...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28265013/absent-filling-of-ipsilateral-superficial-middle-cerebral-vein-is-associated-with-poor-outcome-after-reperfusion-therapy
#12
Sheng Zhang, Yangxiao Lai, Xinfa Ding, Mark Parsons, John H Zhang, Min Lou
BACKGROUND AND PURPOSE: Our aim was to study the effect of drainage of cortical veins, including the superficial middle cerebral vein (SMCV), vein of Trolard, and vein of Labbé on neurological outcomes after reperfusion therapy. METHODS: Consecutive ischemic stroke patients who underwent pretreatment computed tomographic perfusion and 24-hour computed tomographic perfusion or magnetic resonance perfusion after intravenous thrombolysis were included. We defined "absent filling of ipsilateral cortical vein" (eg, SMCV-) as no contrast filling of the vein across the whole venous phase on 4-dimensional computed tomographic angiography in the ischemic hemisphere...
March 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28263342/surveys-of-stroke-patients-and-their-next-of-kin-on-their-opinions-towards-decision-making-and-consent-for-stroke-thrombolysis
#13
Nithia Angamuthu, Kian Kheng Queck, Sumytra Menon, Shu Swen Ho, Elaine Ang, Deidre Anne De Silva
INTRODUCTION: Early initiation of stroke thrombolysis is associated with improved outcomes. Procurement of consent is a key factor in prolonging the door-to-needle duration. This study aimed to determine the attitudes and preferences of stroke patients and their next of kin (NOK) towards decision-making for stroke thrombolysis in Singapore. MATERIALS AND METHODS: We surveyed acute ischaemic stroke patients (n = 171) who presented beyond the 4.5-hour therapeutic window and their NOK (n = 140) using a questionnaire with scenarios on obtaining consent for intravenous thrombolysis...
February 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28262403/clinical-predictors-for-favorable-outcomes-from-endovascular-recanalization-in-wake-up-stroke
#14
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...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28262244/risk-adapted-management-of-pulmonary-embolism
#15
Stefano Barco, Stavros V Konstantinides
The presence and severity of right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of pulmonary embolism (PE). Risk-adapted treatment strategies continue to evolve, tailoring initial management to the clinical presentation and the functional status of the RV. Beyond pharmacological and, if necessary, mechanical circulatory support, systemic thrombolysis remains the mainstay of treatment for hemodynamically unstable patients; in contrast, it is not routinely recommended for intermediate-risk PE...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28261510/is-intravenous-heparin-a-contraindication-for-tpa-in-ischemic-stroke
#16
Zain Kulairi, Nisha Deol, Renee Tolly, Rohan Manocha, Maliha Naseer
There are approximately 2 million cardiac catheterizations that occur every year in the United States and with an aging population this number continues to rise. Adverse events due to this procedure occur at low rates and include stroke, arrhythmia, and myocardial infarctions. Due to the high volume of procedures there are a growing number of adverse events. Stroke after cardiac catheterization (SCC) has an incidence between 0.27 and 0.5% and is one of the most debilitating complications leading to high rates of mortality and morbidity...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28258802/endovascular-stroke-treatment-of-acute-tandem-occlusion-a-single-center-experience
#17
Fabrizio Sallustio, Caterina Motta, Giacomo Koch, Silvia Pizzuto, Bruce C V Campbell, Marina Diomedi, Barbara Rizzato, Alessandro Davoli, Giorgio Loreni, Daniel Konda, Matteo Stefanini, Sebastiano Fabiano, Enrico Pampana, Paolo Stanzione, Roberto Gandini
PURPOSE: To evaluate outcomes and prognostic factors in patients with acute ischemic stroke caused by tandem internal carotid artery/middle cerebral artery occlusion undergoing endovascular treatment. MATERIALS AND METHODS: Characteristics of consecutive patients with tandem occlusion (TO) were extracted from a prospective registry. Collateral vessel quality on pretreatment computed tomographic (CT) angiography was evaluated on a 4-point grading scale, and patients were dichotomized as having poor or good collateral flow...
February 28, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28251328/efficacy-and-safety-of-direct-aspiration-first-pass-technique-versus-stent-retriever-thrombectomy-in-acute-basilar-artery-occlusion-a-retrospective-single-center-experience
#18
Johannes C Gerber, Dirk Daubner, Daniel Kaiser, Kay Engellandt, Kevin Haedrich, Angela Mueller, Volker Puetz, Jennifer Linn, Andrij Abramyuk
INTRODUCTION: The study aimed to compare efficacy and safety of aspiration thrombectomy (AT) to stentriever thrombectomy (SRT) in patients with basilar artery (BA) occlusion (BAO). METHODS: We retrospectively included patients with the following characteristics: acute BAO or occlusion of the intracranial vertebral artery (ICVA) and endovascular therapy (EVT) with stentriever (SRT) or aspiration thrombectomy (AT). Additional extra- but not intracranial EVT and intravenous thrombolysis (IVT) were allowed...
March 1, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28243834/sodium-tanshinone-iia-sulfonate-enhances-effectiveness-rt-pa-treatment-in-acute-ischemic-stroke-patients-associated-with-ameliorating-blood-brain-barrier-damage
#19
Biying Ji, Fei Zhou, Lijuan Han, Jun Yang, Haijian Fan, Shanshan Li, Jingwei Li, Xin Zhang, Xiaoying Wang, Xiangyan Chen, Yun Xu
Treatment with sodium tanshinone IIA sulfonate (STS) may ameliorate blood-brain barrier (BBB) damage in acute ischemic stroke patients receiving recombinant tissue plasminogen activator (rt-PA) thrombolysis and improve stroke patients' outcome. This randomized, single-center, placebo-controlled clinical trial investigated the potential effects and underlying mechanisms of STS. Forty-two acute ischemic stroke patients receiving intravenous rt-PA thrombolysis were randomized to intravenous administration either with STS (60 mg/day) (n = 21) or with equivalent volume of saline as a placebo (n = 21) after randomization for 10 days...
February 27, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28242809/correction-to-sex-differences-and-functional-outcome-after-intravenous-thrombolysis
#20
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Stroke; a Journal of Cerebral Circulation
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