PubMed Journals Articles About "Alteplase Mechanical Thrombolysis Alteplase Stroke" RSS

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Showing "Alteplase mechanical thrombolysis Alteplase Stroke" PubMed Articles 1–25 of 4,600+

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Thromboelastographic Changes in Patients Experiencing an Acute Ischemic Stroke and Receiving Alteplase.

Thromboelastography is a method of measuring whole-blood coagulation changes and has been used to guide therapy and monitor changes in a variety of disease states. However, few studies have investigated the thromboelastographic changes experienced in a patient who has received alteplase for an acute ischemic stroke. This pilot study sought to describe the effect of alteplase on the thromboelastogram tracings of patients experiencing an acute ischemic stroke.

Circadian variation in the effect of intravenous thrombolysis after non-lacunar stroke.

The onset of non-lacunar stroke symptoms has a circadian variation, with a higher risk in the early morning hours and lower risk during the nighttime period, but this circadian distribution has not been clearly established on the effect of intravenous (IV) thrombolysis. The aim of the present study was to assess whether the time interval based on time of Alteplase IV infusion may influence the effect of treatment in patients with non-lacunar stroke. We conducted an analysis on prospectively collected data o...

Bolus-Infusion Delays of Alteplase during Thrombolysis in Acute Ischaemic Stroke and Functional Outcome at 3 Months.

Background. The efficacy of alteplase in acute ischaemic stroke (AIS) is highly time dependent. Hence, alteplase is administered as soon as possible with a bolus followed by an infusion. Delays between bolus and infusion may occur, but the extent of these delays and the impact on outcome are unclear. Aims. We investigated the extent of bolus-infusion delays and the relationship between delays and stroke outcome. Method. We reviewed medical records of 276 patients who received alteplase for AIS at our centre...

Successful thrombolysis of stroke with intravenous alteplase in the third trimester of pregnancy.

Antithrombotic drugs and ischaemic stroke.

About 80% of strokes are ischaemic. Approximately 12% of patients die within 3 months following stroke, and another 20% are institutionalised or become highly dependent. In early 2013, what is the harm-benefit balance of antithrombotic treatments used in the acute phase of ischaemic stroke? To answer this question, we reviewed the available data using the standard Prescrire methodology. Clinical trials of aspirin in the acute phase of ischaemic stroke consist mainly of two randomised trials including a tota...

Asymmetric oro-facial angioedema following alteplase for acute ischaemic stroke.

We present a patient with asymmetric oro-facial angioedema following thrombolysis for acute ischaemic stroke with serial photographs of this phenomenon. We discuss the mechanism for the development of asymmetric oro-facial oedema following thrombolysis and suggest a management plan.

Risk Factors Associated with Bleeding After Alteplase Administration for Pulmonary Embolism: A Case-Control Study.

To identify risk factors associated with bleeding in patients who received alteplase for pulmonary embolism (PE), with a specific focus on risk factors available to the clinician at the time thrombolytics are being considered.

Treatment of ischemic stroke with r-tPA: implementation challenges in a tertiary hospital in Brazil.

Purpose: This paper presents the initial experience with thrombolysis for acute ischaemic stroke at Hospital de Base do Distrito Federal (HBDF), Brazil, and the difficulties associated with the implementation of this treatment. Method: A retrospective study was performed using the medical records of all patients with acute stroke who were treated with intravenous alteplase in our department, between May 2011 and April 2012. Results: The thrombolytic therapy was administered to 32 patients. The mean time bet...

Telestroke in an Urban Setting.

Abstract Background: Telestroke is a viable alternative in rural areas where neurologists or stroke expertise is unavailable. Urban applications of telestroke have not been previously described. Materials and Methods: All patients evaluated using remote telestroke technology at four urban spoke hospitals between March 2011 and March 2013 were included in this analysis. Telestroke services were provided by vascular fellowship-trained neurologists at one academic stroke center. Patient characteristics, time t...

Proposed Approach to Thrombolysis in Dabigatran-Treated Patients Presenting with Ischemic Stroke.

Acute ischemic stroke thrombolysis in patients taking dabigatran is controversial because of a presumed increased risk of symptomatic hemorrhagic transformation. Using data from our local hematopathology laboratory, we developed a thrombolysis protocol for acute ischemic stroke patients taking dabigatran.

Cost-Effectiveness of Optimizing Acute Stroke Care Services for Thrombolysis.

Thrombolysis in acute stroke is effective up to 4.5 hours after symptom onset but relies on early recognition, prompt arrival in hospital, and timely brain scanning. This study aimed to establish the cost-effectiveness of increasing thrombolysis rates through a series of hypothetical change strategies designed to optimize the acute care pathway for stroke.

Ischemic stroke - Interventional therapy.

In addition to the long-established local thrombolysis by means of a catheter, other mechanical procedures for the interventional treatment of acute ischemic stroke have been introduced over the last ten years. These new methods have proved to be effective for the recanalization of occluded vessels supplying the brain and can, in principle, also be employed outside of the therapeutic window valid for intravenous thrombolysis. For just this reason such interventionaltherapies are being increasingly used, als...

Stroke Thrombolysis: Save a Minute, Save a Day.

Stroke thrombolysis is highly time-critical, but data on long-term effects of small reductions in treatment delays have not been available. Our objective was to quantify patient lifetime benefits gained from faster treatment.

Thrombolysis in patients with lacunar stroke is safe: an observational study.

Research suggests that the etiology of lacunar stroke is different from that of other stroke subtypes. This could imply an altered response to thrombolysis, but data concerning the efficacy of rt-PA in lacunar stroke is limited and inconsistent. From our prospectively collected stroke database, we identified patients with an MRI-confirmed purely lacunar stroke that were treated in our Stroke Unit between 2004 and 2011. We compared both the clinical course (NIHSS, deterioration, mRS at 3 months) and the MRI...

Advance Preferences Regarding Thrombolysis in Patients At-Risk for Stroke: A Cross-Sectional Study.

It is difficult to obtaining informed consent for thrombolysis in stroke patients given the emergency setting, the need for a speedy decision and the effects of neurological deficits.

Imaging of acute stroke prior to treatment: Current practice and evolving techniques.

Standard imaging in acute stroke is undertaken with the aim of diagnosing the underlying cause and excluding stroke mimics. In the presence of ischaemic stroke, imaging is also needed to assess patient suitability for treatment with intravenous thrombolysis. Non-contrast CT is predominantly used but MRI can also exclude any contra-indications to thrombolysis treatment. Advanced stroke imaging such as CT and MR angiography and perfusion imaging are increasingly used in an acute setting. In this review, we di...

Mild Hypothermia After Intravenous Thrombolysis in Patients With Acute Stroke: A Randomized Controlled Trial.

Hypothermia improves outcome in resuscitated patients and newborns with hypoxic brain injury. We studied the safety and feasibility of mild hypothermia in awake patients with stroke after intravenous thrombolysis.

Trapped cerebral thrombectomy device: A case report of a rare complication.

Intravenous thrombolysis with recombinant tissue plasminogen activator is currently the standard therapy for acute ischaemic stroke when started within 4.5 h of symptom onset. Systemic thrombolytic therapy can, however, lead to potentially lethal bleeding complications and is contra-indicated in several circumstances. Intra-arterial thrombolysis and/or intra-arterial thrombectomy can overcome these drawbacks and even increase the rate of recanalization. While intravenous thrombolysis is a relatively non-c...

Attitudes and Practices on the Consent Process and Decision-making for Intravenous Stroke Thrombolysis: Physicians' Perspective.

Introduction: Earlier treatment with intravenous stroke thrombolysis improves outcomes and lowers risk of bleeding complications. The decision-making and consent process is one of the rate-limiting steps in the duration between hospital arrival and treatment initiation. We aim to describe the attitudes and practices of neurologists in Singapore on the consent and decision-making processes for stroke thrombolysis. Materials and Methods: A survey of neurologists and neurologists-in-training in 2 large tertiar...

Trends of the Incidence of Ischemic Stroke Thrombolysis over Seven Years and One-Year Outcome: A Population-Based Study in Joinville, Brazil.

In a population-based setting, we aimed to measure the incidence trends of ischemic stroke (IS) thrombolysis, thrombolysis times, proportion of symptomatic intracerebral hemorrhage (sICH), 30-day case fatality and functional outcomes. We also compared the 12-month functional status between thrombolyzed and nonthrombolyzed patients.

Free-floating right heart thrombi in pulmonary embolism.

Background: There is little published evidence on the treatment of mobile masses in the right heart. We report the clinical courses of three consecutive patients presenting with acute pulmonary embolism and mobile masses in the right heart. History and admission findings: Three women, aged 75, 72 and 52 years, were hospitalized within three months because of dyspnea and suspected pulmonary embolism. Investigations: Transthoracic echocardiography revealed right ventricular dysfunction and highly mobile masse...

Imaging predictors of outcome following intravenous thrombolysis in acute stroke.

Intravenous tissue plasminogen activator is the only approved medical treatment for patients with acute ischemic stroke. While it is associated with excellent clinical outcome in about 30 %, even with timely thrombolysis administration, certain strokes continue to evolve and lead to poor outcomes. Several studies have attempted to identify predictors of outcome despite timely thrombolysis. Persistence of a proximal clot burden and large vessel occlusion following thrombolysis are markers for patients who m...

Prediction of the prognosis of ischemic stroke patients after intravenous thrombolysis using artificial neural networks.

In general, around 80% of all strokes are ischemic. Take caring of the patients who have suffered an ischemic stroke is both expensive and time consuming. It is known that thrombolysis in patients with ischemic stroke can reduce the disability and increase the survival rate, however some patients still have poor outcomes. Therefore, to be able to predict the outcome of ischemic stroke patients after intravenous thrombolysis would be useful while making clinical decisions. In this study, we collected retrosp...

New antiplatelet agents prescribed to patients with ischemic heart disease: implications for treatment of stroke.

Stroke continues to be a significant public health problem worldwide. Despite a number of clinical trials testing various therapeutic agents, we are still left with a small armamentarium of options. Aspirin, clopidogrel and combination aspirin-dipyridamole remain the mainstay for prevention of recurrent ischemic stroke. Tissue plasminogen activator (tPA) or alteplase is the sole agent used in the acute phase up to 4.5 h from the onset of stroke symptoms. A greater understanding of pathophysiologic mechanis...

Analysis of barriers to the use of thrombolytics in ischemic stroke in a private hospital in Rio de Janeiro, Brazil.

Ischemic stroke is a major cause of neurological sequelae and death. The correct use of thrombolytic therapy faces several barriers. The objective was to discuss barriers to thrombolytic therapy in a private hospital. This was a retrospective cohort study of patients with symptoms of acute ischemic stroke entering the emergency department of a private hospital in Rio de Janeiro, Brazil, from 2009 to 2011. 257 patients were admitted with suspected ischemic stroke. Among the 156 patients with confirmed diagno...

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