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

22:02 EDT 27th April 2015 | BioPortfolio

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Showing "Alteplase mechanical thrombolysis Alteplase Stroke" PubMed Articles 1–25 of 4,500+

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Successful use of Alteplase during cardiopulmonary resuscitation following massive PE in a patient presenting with ischaemic stroke and haemorrhagic transformation.

The management of patients with acute stroke regarding treatment of thromboembolism is supported by a limited evidence base. We present the case of a 55-year-old female patient who initially presented with an ischaemic cerebral infarct with haemorrhagic transformation. Her clinical recovery was complicated by cardiac arrest secondary to massive pulmonary embolism. This was successfully treated with cardiopulmonary resuscitation and thrombolysis using Alteplase, which led to a full recovery to the pre-arrest...

Effects of Edaravone, a Free Radical Scavenger, on Circulating Levels of MMP-9 and Hemorrhagic Transformation in Patients with Intravenous Thrombolysis Using Low-dose Alteplase.

Matrix metalloproteinase-9 (MMP-9) plays a key role for the blood-brain barrier disruption and intravenous tissue plasminogen activator (iv-tPA) therapy increases MMP-9. Edaravone, a free radical scavenger, reduces MMP-9-related blood-brain barrier disruption. We aimed to investigate whether edaravone would suppress the MMP-9 increase after iv-tPA using low-dose alteplase (0.6 mg/kg).

Alteplase in Acute Ischemic Stroke: Putting the Guidelines into Practice.

Intravenous recombinant tissue plasminogen activator (rt-PA or alteplase) is the only approved medical intervention for treatment of acute ischemic stroke within the first hours of symptom onset. In this article, we review the preliminary studies of rt-PA in acute ischemic stroke that led to US FDA approval of its use within 3 h of symptom onset. The studies on rt-PA for use beyond 3 h of symptom onset and future reperfusion therapies are discussed. Overviews of the clinical presentation and treatment of ...

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.

Alteplase for ischaemic stroke.

Low-Dose Alteplase Infusion for the Treatment of Mechanical Aortic Valve Thrombosis: A Spotlight on the Importance of Medication Adherence.

A rare, yet serious, complication of mechanical heart valves is symptomatic obstructive prosthetic valve thrombosis. The risk of valve thrombosis is magnified in patients who are nonadherent to prescribed anticoagulation. In this case report, we describe a 48-year-old male patient with a history of mechanical aortic valve replacement surgery, who stopped taking prescribed warfarin therapy 2 years before presentation and subsequently developed acute decompensated heart failure secondary to valvular dysfuncti...

Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection.

Background Trials of endovascular therapy for ischemic stroke have produced variable results. We conducted this study to test whether more advanced imaging selection, recently developed devices, and earlier intervention improve outcomes. Methods We randomly assigned patients with ischemic stroke who were receiving 0.9 mg of alteplase per kilogram of body weight less than 4.5 hours after the onset of ischemic stroke either to undergo endovascular thrombectomy with the Solitaire FR (Flow Restoration) stent re...

Pooled RCTs: Alteplase within 4.5 hours of ischemic stroke improves the likelihood of good outcome.

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...

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...

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...

Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke.

Background Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of patients die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment in addition to standard care in patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation. Methods We randomly assigned participants to receive standard care (...

Development of a computerised decision aid for thrombolysis in acute stroke care.

Thrombolytic treatment for acute ischaemic stroke improves prognosis, although there is a risk of bleeding complications leading to early death/severe disability. Benefit from thrombolysis is time dependent and treatment must be administered within 4.5 hours from onset of symptoms, which presents unique challenges for development of tools to support decision making and patient understanding about treatment. Our aim was to develop a decision aid to support patient-specific clinical decision-making about thr...

Thrombolysis in left mechanical prosthetic heart valve obstruction by thrombus. Following and results.

Obstruction of the left mechanical heart valve by a thrombus is a serious complication. The factors associated with mortality are functional class, type of valve prosthesis and emergency surgery. Thrombolysis represents a therapeutic option to cardiac surgery. The aim of this investigation was to analyze the role of thrombolysis in the management of thrombus-obstructed left mechanical heart valve.

Modern treatment of acute ischemic stroke.

Acute ischemic stroke is a frequent cause of death and disability. Therepautic scepticism persists both among doctors and lay people. However, modern reperfusion therapy improved outcomes of acute stroke patients - at least of those presenting early after symptom onset. This review presents multidisciplinary approach to acute stroke - cooperation of neurologists, cardiologists and radiologists. Both reperfusion strategies are discussed: catheter-based thrombectomy and thrombolysis.Key words: stroke - cathet...

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...

Effects of Golden Hour Thrombolysis: A Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) Substudy.

The effectiveness of intravenous thrombolysis in acute ischemic stroke is time dependent. The effects are likely to be highest if the time from symptom onset to treatment is within 60 minutes, termed the golden hour.

Recognition of posterior circulation stroke.

Better identification and triage of acute posterior circulation (PC) stroke patients is needed as the PC ischemic stroke (IS) patients may be allowed longer thrombolysis window than anterior circulation (AC) IS patients and PC patients with hemorrhagic stroke (ICH) may require care in a neurosurgical unit possibly remote from stroke unit.

IV t-PA Influences Infarct Volume in Minor Stroke: A Pilot Study.

There is an ongoing debate whether stroke patients presenting with minor or moderate symptoms benefit from thrombolysis. Up until now, stroke severity on admission is typically measured with the NIHSS, and subsequently used for treatment decision.

Blood pressure management in stroke: Five new things.

Hypertension is a major modifiable risk factor for stroke, with an estimated 51% of stroke deaths being attributable to high systolic blood pressure globally.(1,2) The management of hypertension in stroke is determined by timing, the type of stroke, use of thrombolysis, concurrent medical conditions, and pharmacologic variables. We highlight the details of elevated blood pressure management in the hyperacute/acute, subacute, and chronic stages of ischemic stroke and intracerebral hemorrhage.

Thrombectomy vs. Systemic Thrombolysis in Acute Embolic Stroke with High Clot Burden: A Retrospective Analysis.

Purpose: The efficacy of i. v. thrombolysis in acute stroke with high clot burden is limited. Successful recanalization is very unlikely if the thrombus length exceeds 7 mm. Thus this retrospective controlled study evaluated the efficacy and safety of neurothrombectomy in the treatment of acute embolic stroke in patients selected by a thrombus length of ≥ 8 mm using the stent retriever Trevo(®) device. Materials and Methods: 40 patients with acute occlusion of the anterior intracranial arteries w...

Impact of catheter fragmentation followed by local intrapulmonary thrombolysis in acute high risk pulmonary embolism as primary therapy.

Pulmonary embolism (PE) with more than 50% compromise of pulmonary circulation results significant right ventricular (RV) afterload leading to progressive RV failure, systemic hypotension and shock. Prompt restoration of thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy (PMT) prevents progressive hemodynamic decline. We report our single center experience in high risk PE patients treated with standard pigtail catheter mechanical fragmentation followed by intrapulmonary thrombolysis...

Acute Stroke Intervention: A Systematic Review.

Acute ischemic stroke is a major cause of mortality and morbidity in the United States. We review the latest data and evidence supporting catheter-directed treatment for proximal artery occlusion as an adjunct to intravenous thrombolysis in patients with acute stroke.

Acute stroke in patients on new direct oral anticoagulants: how to manage, how to treat?

Introduction: For a long time, vitamin K antagonists (VKA) were the only available oral anticoagulants for clinical use. It is conceivable that the number of patients treated with novel direct oral anticoagulants (NOAC) will increase, due to the easy handling and the favorable risk-benefit profile compared with VKA. It is, therefore, expected that clinicians will be increasingly confronted with the question on how to treat acute ischemic stroke (AIS) if there is an indication for thrombolysis or how to mana...

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