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Stroke AND thrombolysis

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https://www.readbyqxmd.com/read/29027122/hi1a-as-a-novel-neuroprotective-agent-for-ischemic-stroke-by-inhibition-of-acid-sensing-ion-channel-1a
#1
Yandong Ren, Chengchong Li, Jinlong Chang, Rui Wang, Yuhua Wang, Xiang-Ping Chu
Strokes are the second-leading cause of death worldwide, and the cellular and molecular mechanisms underlying stroke-induced brain damage are still uncertain. The present therapy for acute ischemic stroke is limited to thrombolysis with the recombinant tissue plasminogen activator (rtPA). However, rtPA has a narrow therapeutic timeframe of 3-4.5 h, and only approximately 5% of stroke patients can benefit from rtPA treatment. Neuroprotective agents, such as N-methyl-D-aspartate receptor antagonists, have shown great promise in preclinical studies...
October 13, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29026412/the-role-of-manual-thrombectomy-in-cardiovascular-outcome-among-patients-with-total-cutoff-vessel-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#2
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29021849/feasibility-safety-and-potential-demand-of-emergent-brain-magnetic-resonance-imaging-of-patients-with-cardiac-implantable-electronic-devices
#3
Maki Ono, Makoto Suzuki, Mitsuaki Isobe
BACKGROUND: The feasibility, safety, and potential demand of emergent magnetic resonance imaging (MRI) of patients with a cardiac implantable electronic device (CIED) in emergency situations are unknown. METHODS: We retrospectively compared emergent and scheduled MRI orders for patients with CIEDs at Kameda General Hospital, a tertiary hospital in Japan, from October 2012 to September 2016. RESULTS: We identified 11 emergent MRI orders via the emergency room and 38 scheduled MRI orders...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29018133/carotid-web-intimal-fibromuscular-dysplasia-has-high-stroke-recurrence-risk-and-is-amenable-to-stenting
#4
Diogo C Haussen, Jonathan A Grossberg, Mehdi Bouslama, Gustavo Pradilla, Samir Belagaje, Nicolas Bianchi, Jason W Allen, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Carotid webs have been increasingly recognized as a cause of recurrent stroke, but evidence remains scarce. We aim to report the clinical outcomes and first series of carotid stenting in a cohort of patients with strokes from symptomatic carotid webs. METHODS: Prospective and consecutive data of patients <65 years old with cryptogenic stroke admitted within September 2014 to May 2017. Carotid web was defined by a shelf-like/linear filling defect in the posterior internal carotid artery bulb by computed tomographic angiography...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29018132/one-stop-management-of-acute-stroke-patients-minimizing-door-to-reperfusion-times
#5
Marios-Nikos Psychogios, Daniel Behme, Katharina Schregel, Ioannis Tsogkas, Ilko L Maier, Johanna Rosemarie Leyhe, Antonia Zapf, Julia Tran, Mathias Bähr, Jan Liman, Michael Knauth
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT)...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29018130/mechanical-thrombectomy-in-perioperative-strokes-a-case-control-study
#6
Kévin Premat, Olivier Clovet, Giulia Frasca Polara, Eimad Shotar, Bruno Bartolini, Marion Yger, Federico Di Maria, Flore Baronnet, Silvia Pistocchi, Raphaël Le Bouc, Christine Pires, Nader Sourour, Sonia Alamowitch, Yves Samson, Vincent Degos, Frédéric Clarençon
BACKGROUND AND PURPOSE: Perioperative strokes (POS) are rare but serious complications for which mechanical thrombectomy could be beneficial. We aimed to compare the technical results and patients outcomes in a population of POS versus non-POS (nPOS) treated by mechanical thrombectomy. METHODS: From 2010 to 2017, 25 patients with POS (ie, acute ischemic stroke occurring during or within 30 days after a procedure) who underwent mechanical thrombectomy (POS group) were enrolled and paired with 50 consecutive patients with nPOS (control group), based on the occlusion's site, National Institute of Health Stroke Scale, and age...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28991723/infections-and-chlamydia-pneumoniae-antibodies-influence-the-functional-outcome-in-thrombolysed-strokes
#7
Domenico Consoli, Simone Vidale, Marco Arnaboldi, Anna Cavallini, Arturo Consoli, Franco Galati, Donata Guidetti, Giuseppe Micieli, Maurizia Rasura, Roberto Sterzi, Danilo Toni, Domenico Inzitari
OBJECTIVE: Thrombolysis is effective in ischemic stroke patients, but some factors influence its benefit. Previous infections could increase the risk of ischemic stroke by an activation of systemic inflammation. We analysed the influence of previous infections and Chlamydia pneumoniae serology on functional outcome in thrombolysed stroke patients. METHODS: Consecutive thrombolysed stroke patients admitted during calendar year 2011 were analysed. Demographics, vascular risk factors, clinical and aetiological data were registered...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28991718/improving-treatment-times-for-patients-with-in-hospital-stroke-using-a-standardized-protocol
#8
Junpei Koge, Shoji Matsumoto, Ichiro Nakahara, Akira Ishii, Taketo Hatano, Nobutake Sadamasa, Yasutoshi Kai, Mitsushige Ando, Makoto Saka, Hideo Chihara, Wataru Takita, Keisuke Tokunaga, Takahiko Kamata, Hidehisa Nishi, Tetsuya Hashimoto, Atsushi Tsujimoto, Jun-Ichi Kira, Izumi Nagata
BACKGROUND: Previous reports have shown significant delays in treatment of in-hospital stroke (IHS). We developed and implemented our IHS alert protocol in April 2014. We aimed to determine the influence of implementation of our IHS alert protocol. METHODS: Our implementation processes comprise the following four main steps: IHS protocol development, workshops for hospital staff to learn about the protocol, preparation of standardized IHS treatment kits, and obtaining feedback in a monthly hospital staff conference...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28989806/the-progress-of-telestroke-in-china
#9
REVIEW
Gang Zhao, Huan Huang, Fang Yang
Stroke remains the leading cause of death in China. The disparity of distribution in specialists and hospitals affects access to timely stroke care. Telestroke, the use of telemedicine for stroke, may be the solution to access to stroke care. Telestroke can improve the rate of successful intravenous thrombolysis and shorten the time to treatment. Here we review the progress of telestroke in China.
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28989804/the-chinese-stroke-association-scientific-statement-intravenous-thrombolysis-in-acute-ischaemic-stroke
#10
REVIEW
Qiang Dong, Yi Dong, Liping Liu, Anding Xu, Yusheng Zhang, Huaguang Zheng, Yongjun Wang
The most effective medical treatment for acute ischaemic stroke (AIS) is to offer intravenous thrombolysis during the ultra-early period of time after the onset. Even based on the Consensus of Chinese Experts on Intravenous Thrombolysis for AIS in 2012 and 2014 Chinese Guidelines on the Diagnosis and Treatment of AIS, the rate of thrombolysis for AIS in China remained around 2.4%, and the rate of intravenous tissue plasminogen activator usage was only about 1.6% in real world. The indication of thrombolysis for AIS has been expanded, and contraindications have been reduced with recently published studies...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28989802/clopidogrel-loading-dose-versus-maintenance-dose-to-treat-patients-with-acute-ischaemic-stroke-in-china-class-china-results-from-a-prospective-double-blind-randomised-clinical-trial
#11
Ying Zhao, Wanyong Yang, Zefeng Tan, Wenmin Wang, Weimin Xiao, Jinsheng Zeng, Anding Xu
AIM: The role of clopidogrel in treating patients with acute ischaemic stroke is unclear. We have conducted the clinical trial in order to evaluate the efficacy and safety of clopidogrel with a loading dose in treating patients with non-cardiogenic acute ischaemic stroke. METHOD: Clopidogrel loading dose versus maintenance dose to treat patients with acute ischaemic stroke in China (CLASS-China) was a prospective, randomised, double-blind and placebo-controlled clinical trial in China...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28988732/rupture-of-an-occult-intracranial-mycotic-aneurysm-after-intravenous-thrombolysis-with-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#12
Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A James, C Keith Stone
BACKGROUND: The treatment of acute ischemic stroke with recombinant tissue plasminogen activator (rtPA) has become the mainstay of treatment, but its use carries a risk of subsequent intracranial hemorrhage (ICH). Guidelines have been developed to aid in the selection of the appropriate candidates to treat with rtPA to reduce this risk. We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA)...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987854/contact-aspiration-with-the-new-arc%C3%A2-catheter-for-thrombectomy-of-acute-ischemic-stroke-a-single-center-results
#13
Benjamin Gory, Francis Turjman
BACKGROUND/OBJECTIVE: Contact aspiration has gained growing acceptance in the endovascular stroke therapy. The safety and efficacy data of the novel ARC™ catheter (Medtronic, Irvine, CA) used for intracranial thrombectomy was poorly evaluated. We reported our preliminary results with the ARC™ with regard to angiographic reperfusion, duration of thrombectomy, safety, and clinical outcome at 90 days. METHODS: In a single center series including 20 large-vessel occlusion stroke patients prospectively collected, we retrospectively evaluated the safety and efficacy profiles of the ARC™ intracranial catheter for first-line contact aspiration...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987436/ischemic-stroke-advances-in-diagnosis-and-management
#14
REVIEW
Courtney R Cassella, Andy Jagoda
Acute ischemic stroke carries the risk of morbidity and mortality. Since the advent of intravenous thrombolysis, there have been improvements in stroke care and functional outcomes. Studies of populations once excluded from thrombolysis have begun to elucidate candidates who might benefit and thus should be engaged in the process of shared decision-making. Imaging is evolving to better target the ischemic penumbra salvageable with prompt reperfusion. Availability and use of computed tomography angiography identifies large-vessel occlusions, and new-generation endovascular therapy devices are improving outcomes in these patients...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28986410/thrombolysis-in-acute-ischemic-stroke-in-patients-with-dementia-a-swedish-registry-study
#15
Eva Zupanic, Mia von Euler, Ingemar Kåreholt, Beatriz Contreras Escamez, Johan Fastbom, Bo Norrving, Dorota Religa, Milica G Kramberger, Bengt Winblad, Kristina Johnell, Maria Eriksdotter, Sara Garcia-Ptacek
OBJECTIVE: To compare access to intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) and its outcomes in patients with and without dementia. METHODS: This was a longitudinal cohort study of the Swedish dementia and stroke registries. Patients with preexisting dementia who had AIS from 2010 to 2014 (n = 1,356) were compared with matched patients without dementia (n = 6,755). We examined access to thrombolysis and its outcomes at 3 months (death, residency, and modified Rankin Scale [mRS] score)...
October 6, 2017: Neurology
https://www.readbyqxmd.com/read/28986280/recombinant-tissue-plasminogen-activator-induces-long-term-anxiety-like-behaviors-via-the-erk1-2-gad1-gaba-cascade-in-the-hippocampus-of-a-rat-model
#16
Mei-Xue Dong, Chen-Meng Li, Peng Shen, Qing-Chuan Hu, You-Dong Wei, Yi-Fei Ren, Jia Yu, Si-Wen Gui, Yi-Yun Liu, Jun-Xi Pan, Peng Xie
OBJECTIVES: Recombinant tissue plasminogen activator (rtPA) is widely used for patients with thromboembolic disease, and increasing evidence indicates that it can directly induce neurotoxicity independent of its thrombolysis property. Here, we aimed to confirm the long-term effect of rtPA on animal's behavior, and investigate the underlying pathogenesis. METHODS AND RESULTS: Male Sprague-Dawley rats randomly received a dose of rtPA (10 mg/kg) or sterile saline...
October 3, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28986149/factors-associated-with-early-dramatic-recovery-following-successful-recanalization-of-occluded-artery-by-endovascular-treatment-in-anterior-circulation-stroke
#17
Dae-Hyun Kim, Hyun-Wook Nah, Hyun-Seok Park, Jae-Hyung Choi, Myung-Jin Kang, Jae-Kwan Cha
Endovascular treatment (EVT) significantly increases the recanalization rate and improves functional outcomes in acute ischemic stroke. However, despite successful recanalization by EVT, some stroke patients demonstrate no early dramatic recovery (EDR). We assessed factors associated with EDR following recanalization by EVT. We included subjects with anterior circulation stroke treated with EVT who met the following criteria: Thrombolysis in Cerebral Ischemia scores (TICI) 2b-3 after EVT, lesion volume <70mL as seen on the pre-treatment diffusion-weighted imaging (DWI) scan and a baseline NIHSS score ≥6...
October 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28985990/the-importance-of-atrial-fibrillation-and-selected-echocardiographic-parameters-for-the-effectiveness-and-safety-of-thrombolytic-therapy-in-patients-with-stroke
#18
Lasek-Bal Anetta, Kowalewska-Twardela Teresa, Warsz-Wianecka Aldona, Puz Przemysław, Krzan Aleksandra, Cieślik Aleksandra
BACKGROUND: The efficacy and safety of thrombolytic therapy in stroke depend on multiple factors. The aim of this study was to evaluate the significance of atrial fibrillation the prognosis in terms of the functional status in patients with stroke treated with intravenous thrombolysis. An additional aim was also to assess the potential significance of reduced ejection fraction (EF) and enlarged left atrium (LA) of the heart for the prognosis in patients with stroke who underwent thrombolytic therapy...
September 19, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28985592/pharmacological-thrombolysis-for-acute-ischemic-stroke-treatment-gender-differences-in-clinical-risk-factors
#19
Michael J Colello, Lauren E Ivey, Jordan Gainey, Rakiya V Faulkner, Ashleigh Johnson, Leanne Brechtel, Lee Madeline, Thomas I Nathaniel
BACKGROUND: In a stroke population, women have a worse outcome than men when untreated. In contrast, there is no significant difference in treated patients. In this study, we determined whether clinical variables represent a promising approach to assist in the evaluation of gender differences in a stroke population. METHODS: We analyzed data from ischemic stroke patients' ≥18 years-old from the stroke registry on rtPA administration and identified gender differences in clinical factors within inclusion and exclusion criteria in a stroke population that received rtPA...
October 3, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#20
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
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