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thrombolytics in stroke

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https://www.readbyqxmd.com/read/28318959/utility-of-items-of-baseline-national-institutes-of-health-stroke-scale-as-predictors-of-functional-outcomes-at-three-months-after-mild-ischemic-stroke
#1
Jay Chol Choi, Beom Joon Kim, Moon-Ku Han, Soo Joo Lee, Kyusik Kang, Jong-Moo Park, Sang-Soon Park, Tai Hwan Park, Yong-Jin Cho, Keun-Sik Hong, Kyung Bok Lee, Jun Lee, Wi-Sun Ryu, Dong-Eog Kim, Hyun-Wook Nah, Dae-Hyun Kim, Jae-Kwan Cha, Joon-Tae Kim, Kang-Ho Choi, Mi Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Myung Suk Jang, Ji Sung Lee, Juneyoung Lee, Hee-Joon Bae
BACKGROUND: Predicting outcomes of acute stroke patients initially presenting with mild neurologic deficits is crucial in decision making regarding thrombolytic therapy. We examined the utility of individual National Institutes of Health Stroke Scale (NIHSS) score items or clusters of items as predictors of functional outcomes at 3 months after mild stroke. METHODS: Using a multicenter stroke registry database, we identified patients with acute ischemic stroke who presented within 4...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28306132/evaluation-of-functional-outcome-measured-by-modified-rankin-scale-in-rtpa-treated-patients-with-acute-ischemic-stroke
#2
B Georgievski-Brkic, M Savic, D Nikolic, L Nikcevic, M Vukicevic, D Kozic
Aim of our study was to assess functional outcome measured by modified Rankin scale (mRS) in patients that were treated with thrombolytic therapy-recombinant tissue plasminogen activator (rtPA) after acute ischemic stroke. The study included 100 participants that were treated after acute ischemic stroke. Analyzed parameters included: gender; age groups: age 54 and below (Groupup to-54), 55-64 (Group55-64), 65-74 (Group65-74), and 75 and above (Group75-up); cerebral blood flow (CBF) and cerebral blood volume (CBV)...
December 1, 2016: Archives Italiennes de Biologie
https://www.readbyqxmd.com/read/28286764/phase-i-and-phase-ii-therapies-for-acute-ischemic-stroke-an-update-on-currently-studied-drugs-in-clinical-research
#3
REVIEW
Cesar Reis, Onat Akyol, Wing Mann Ho, Camila Araujo, Lei Huang, Richard Applegate Ii, John H Zhang
Acute ischemic stroke is a devastating cause of death and disability, consequences of which depend on the time from ischemia onset to treatment, the affected brain region, and its size. The main targets of ischemic stroke therapy aim to restore tissue perfusion in the ischemic penumbra in order to decrease the total infarct area by maintaining blood flow. Advances in research of pathological process and pathways during acute ischemia have resulted in improvement of new treatment strategies apart from restoring perfusion...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28283876/purification-of-serine-protease-from-polychaeta-lumbrineris-nipponica-and-assessment-of-its-fibrinolytic-activity
#4
Seung Ju Yeon, Goo Yong Chung, Jae Sang Hong, Jin Ha Hwang, Hwa Sung Shin
Ischemic stroke and cardiovascular disease can occur from blockage of blood vessels by fibrin clots formed naturally in the body. Therapeutic drugs of anticoagulant or thrombolytic agents have been studied; however, various problems have been reported such as side effects and low efficacy. Thus, development of new candidates that are more effective and safe is necessary. The objective of this study is to evaluate fibrinolytic activity, anti-coagulation, and characterization of serine protease purified from Lumbrineris nipponica, polychaeta, for new thrombolytic agents...
March 10, 2017: In Vitro Cellular & Developmental Biology. Animal
https://www.readbyqxmd.com/read/28279987/risk-of-thrombus-fragmentation-during-endovascular-stroke-treatment
#5
J Kaesmacher, T Boeckh-Behrens, S Simon, C Maegerlein, J F Kleine, C Zimmer, L Schirmer, H Poppert, T Huber
BACKGROUND AND PURPOSE: Periprocedural thrombus fragmentation is a relevant risk in endovascular stroke treatment. Because factors influencing its occurrence are largely unknown, this study addresses a potential relationship between thrombus histology and clot stability. MATERIALS AND METHODS: Eighty-five patients with anterior circulation stroke treated with thrombectomy were included in this retrospective study. The number and location of emboli after retrieving the primary thrombus, the number of maneuvers, and TICI scores were evaluated...
March 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28277464/clot-imaging-in-large-vessel-occlusion-strokes
#6
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/28277445/thrombolytic-therapy-in-wake-up-stroke-patients
#7
Gretchen M Stern, Nicholas Van Hise, Lindsay M Urben, Matthew J Korobey, Jamie M Pitlick, Andrew J Crannage
OBJECTIVE: The aim of the study is to review existing and ongoing trial data on wake-up stroke (WUS) patients for thrombolytic therapy. METHODS: A literature search was conducted in PubMed (conception-October 2016) using the terms wake-up stroke, acute ischemic stroke, wake-up thrombolysis, computed tomography imaging in wake-up stroke, and magnetic resonance imaging in wake-up stroke. Ongoing trials were found using the ClinicalTrials.gov website. RESULTS: The search yielded 61 articles in PubMed and 7 ongoing trials...
March 9, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28275084/reduction-in-time-to-treatment-in-prehospital-telemedicine-evaluation-and-thrombolysis
#8
Ather Taqui, Russell Cerejo, Ahmed Itrat, Farren B S Briggs, Andrew P Reimer, Stacey Winners, Natalie Organek, Andrew B Buletko, Lila Sheikhi, Sung-Min Cho, Maureen Buttrick, Megan M Donohue, Zeshaun Khawaja, Dolora Wisco, Jennifer A Frontera, Andrew N Russman, Fredric M Hustey, Damon M Kralovic, Peter Rasmussen, Ken Uchino, Muhammad S Hussain
OBJECTIVE: To compare the times to evaluation and thrombolytic treatment of patients treated with a telemedicine-enabled mobile stroke treatment unit (MSTU) vs those among patients brought to the emergency department (ED) via a traditional ambulance. METHODS: We implemented a MSTU with telemedicine at our institution starting July 18, 2014. A vascular neurologist evaluated each patient via telemedicine and a neuroradiologist and vascular neurologist remotely assessed images obtained by the MSTU CT...
March 8, 2017: Neurology
https://www.readbyqxmd.com/read/28269641/peripheral-sensory-stimulation-is-neuroprotective-in-a-rat-photothrombotic-ischemic-stroke-model
#9
Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor
Ischemic stroke is one of the leading causes of death and disability in the world. Thrombolytic therapy using recombinant tissue plasminogen activator (rtPA), the only FDA-approved drug for acute ischemia, is limited by a narrow therapeutic time window and risk of hemorrhage. There is a serious need for a neuroprotective therapy which is clinically viable. We earlier demonstrated that peripheral sensory stimulation (PSS) is a potential therapeutic intervention for hyperacute ischemia resulting in recovery of neurovascular functions when administered immediately following ischemia onset in a rat model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268390/in-vitro-examination-of-the-pressure-effect-on-clot-dissolution-with-thrombolytic-patch
#10
Zhen Qin, Chi Hang Chon, John C K Kwok, David C C Lam
Bio-kinetic thrombus dissolution model has been developed to describe the thrombus dissolution behavior during endoluminal thrombolytic patch treatment to recanalize blocked vessel in ischemic strokes. The initial model ignored the effect of pulsatile pressure in the lumen. However, pulsatile pressure in the lumen may affect molecule diffusion and bio-chemical reaction rate and accelerate clot dissolution. The effect of pressure on the dissolution rate was examined in this study. The dissolution behaviors of 100-400 μm thick blood clot specimens subject to diastolic, systolic, and pulsatile pressure were characterized using Raman spectroscopy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265861/re-evaluate-the-efficacy-and-safety-of-human-urinary-kallidinogenase-resk-protocol-for-an-open-label-single-arm-multicenter-phase-iv-trial-for-the-treatment-of-acute-ischemic-stroke-in-chinese-patients
#11
Jun Ni, Jiazhi Qu, Ming Yao, Zhijun Zhang, Xihua Zhong, Liying Cui
Acute ischemic stroke (AIS) is a major medical challenge in China. Thrombolytic drugs recommended for the treatment of AIS usually have a narrow time window. Human urinary kallidinogenase (HUK) was approved by the China Food and Drug Administration (CFDA) in 2005 for the treatment of mild to moderate AIS, and it is thus widely used in China. However, large-scale clinical study data for a more complete understanding of various aspects of its safety and efficacy characteristics are still unavailable. The ongoing Reevaluate the Efficacy and Safety of Human Urinary Kallidinogenase (RESK) trial is designed to reevaluate the safety and efficacy of HUK in Chinese patients with AIS...
March 6, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28258876/the-use-of-tissue-plasminogen-activator-in-the-treatment-of-wallenberg-syndrome-caused-by-vertebral-artery-dissection
#12
Alexis Salerno, Bradford V Cotter, Michael E Winters
BACKGROUND: Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. The administration of a thrombolytic medication has been recommended in the treatment of patients with stroke caused by cervical artery dissection...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28250755/computed-tomography-perfusion-and-computed-tomography-angiography-for-prediction-of-clinical-outcomes-in-ischemic-stroke-patients-after-thrombolysis
#13
Jia-Wei Pan, Xiang-Rong Yu, Shu-Yi Zhou, Jian-Hong Wang, Jun Zhang, Dao-Ying Geng, Tian-Yu Zhang, Xin Cheng, Yi-Feng Ling, Qiang Dong
Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis. At present, the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment, with less attention to predictions of outcomes after thrombolysis. Thus, in the present study, we assessed the efficacy of combined computed tomography (CT) perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28248913/pitfalls-and-rewards-for-implementing-ocular-motor-testing-in-acute-vestibular-syndrome-a-pilot-project
#14
Oana M Dumitrascu, Sam Torbati, Mourad Tighiouart, David E Newman-Toker, Shlee S Song
OBJECTIVES: Isolated acute vestibular syndrome (iAVS) presentations to the emergency department (ED) pose management challenges, given the concerns for posterior circulation strokes. False-negative brain imaging may erroneously reassure clinicians, whereas HINTS-plus examination outperforms imaging to screen for strokes in iAVS. We studied the feasibility of implementing HINTS-plus testing in the ED, aiming to reduce neuroimaging in patients with iAVS. METHODS: We launched an institutional Quality Improvement initiative, using DMAIC methodology...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28236599/microbubble-based-sonothrombolysis-using-a-planar-rectangular-ultrasonic-transducer
#15
Nicos Papadopoulos, Christakis Damianou
BACKGROUND: The aim of the proposed study was to evaluate in an in vitro flow model the ability of small planar rectangular (2 × 10 mm(2)) ultrasonic transducer to enhance thrombolysis induced by the thrombolytic agent tenecteplase (TNK-tPA). METHODS: To provide a more realistic clinical environment of stroke, the study was conducted under realistic flow conditions and TNK-tPA concentrations. Fully retracted porcine blood clots were used to determine the thrombolytic efficacy of ultrasound (US) waves as an adjunct to TNK-tPA or in combination with microbubbles (MBs)...
February 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28228620/a-case-of-intracranial-arterial-dolichoectasia-with-4-repeated-cerebral-infarctions-in-6-months-and-enlargement-of-basilar-artery
#16
Hideyuki Moriyoshi, Soma Furukawa, Mai Iwata, Junichiro Suzuki, Noriyoshi Nakai, Suguru Nishida, Yasuhiro Ito
A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy...
February 22, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28228323/evaluation-of-the-role-of-susceptibility-weighted-imaging-in-thrombolytic-therapy-for-acute-ischemic-stroke
#17
Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang
We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA)...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28227899/peripheral-sensory-stimulation-is-neuroprotective-in-a-rat-photothrombotic-ischemic-stroke-model
#18
Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor, Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor, Lun-De Liao, Nitish V Thakor, Frances Lim, Chua Le Teng Sherry, Aishwarya Bandla, Chan Kim Chuan
Ischemic stroke is one of the leading causes of death and disability in the world. Thrombolytic therapy using recombinant tissue plasminogen activator (rtPA), the only FDA-approved drug for acute ischemia, is limited by a narrow therapeutic time window and risk of hemorrhage. There is a serious need for a neuroprotective therapy which is clinically viable. We earlier demonstrated that peripheral sensory stimulation (PSS) is a potential therapeutic intervention for hyperacute ischemia resulting in recovery of neurovascular functions when administered immediately following ischemia onset in a rat model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226557/in-vitro-examination-of-the-pressure-effect-on-clot-dissolution-with-thrombolytic-patch
#19
Zhen Qin, Chi Hang Chon, John C K Kwok, David C C Lam, Zhen Qin, Chi Hang Chon, John C K Kwok, David C C Lam, Chi Hang Chon, David Cc Lam, Zhen Qin, John Ck Kwok
Bio-kinetic thrombus dissolution model has been developed to describe the thrombus dissolution behavior during endoluminal thrombolytic patch treatment to recanalize blocked vessel in ischemic strokes. The initial model ignored the effect of pulsatile pressure in the lumen. However, pulsatile pressure in the lumen may affect molecule diffusion and bio-chemical reaction rate and accelerate clot dissolution. The effect of pressure on the dissolution rate was examined in this study. The dissolution behaviors of 100-400 μm thick blood clot specimens subject to diastolic, systolic, and pulsatile pressure were characterized using Raman spectroscopy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28218337/long-term-outcome-after-reperfusion-treated-stroke
#20
Oscar Mühr, Hanna C Persson, Katharina S Sunnerhagen
OBJECTIVE: To explore motor function, health-related quality of life and impact on activities of daily living 5 and 6 years after reperfusion treatment in patients with stroke. METHODS: A total of 75 patients with first-time stroke received either thrombectomy or thrombolytic treatment at the Sahlgrenska University Hospital in Gothenburg during an 18-month period in 2009-2010. Follow-up involved questionnaires and clinical examinations, 5 and 6 years post-stroke...
February 17, 2017: Journal of Rehabilitation Medicine
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