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 4,400+

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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 ...

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.

Progress in Intravenous Thrombolytic Therapy for Acute Stroke.

Intravenous recombinant tissue plasminogen activator (alteplase) was approved by the US Food and Drug Administration in 1996 for the treatment of acute ischemic stroke. Nearly 20 years later, it remains the only approved treatment, despite limitations in both efficacy and safety. With a growing capacity for stroke treatment worldwide, physicians need to understand where we have come from and what the future of stroke treatment might be.

Intravenous thrombolysis guided by a telemedicine consultation system for acute ischaemic stroke patients in China: the protocol of a multicentre historically controlled study.

The rate of intravenous thrombolysis with tissue-type plasminogen activator or urokinase for stroke patients is extremely low in China. It has been demonstrated that a telestroke service may help to increase the rate of intravenous thrombolysis and improve stroke care quality in local hospitals. The aim of this study, also called the Acute Stroke Advancing Program, is to evaluate the effectiveness and safety of decision-making concerning intravenous thrombolysis via a telemedicine consultation system for ac...

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 (...

Tailored approaches to stroke health education (TASHE): study protocol for a randomized controlled trial.

Stroke is a leading cause of adult disability and mortality. Intravenous thrombolysis can minimize disability when patients present to the emergency department for treatment within the 3 - 4½ h of symptom onset. Blacks and Hispanics are more likely to die and suffer disability from stroke than whites, due in part to delayed hospital arrival and ineligibility for intravenous thrombolysis for acute stroke. Low stroke literacy (poor knowledge of stroke symptoms and when to call 911) among Blacks and His...

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.

Parenchymal FLAIR hyperintensity before thrombolysis is a prognostic factor of ischemic stroke outcome at 3 Tesla.

The goal of the present study was to determine whether the presence or absence of parenchymal FLAIR hyperintensity alone, before thrombolysis, might be a predictive factor of ischemic stroke outcomes after the acute phase of stroke and at 3 months.

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...

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...

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.

Comparison of statistical and operational properties of subject randomization procedures for large multicenter clinical trial treating medical emergencies.

Large multicenter acute stroke trials demand a randomization procedure with a high level of treatment allocation randomness, an effective control on overall and within-site imbalances, and a minimized time delay of study treatment caused by the randomization procedure. Driven by the randomization algorithm design of A Study of the Efficacy and Safety of Activase (Alteplase) in Patients with Mild Stroke (PRISMS) (NCT02072226), this paper compares operational and statistical properties of different randomizat...

Robotic Telepresence Versus Standardly Supervised Stroke Alert Team Assessments.

Abstract Background: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center. Materials and Methods: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessment...

Trends in yield of a code stroke program for enhancing thrombolysis.

As the benefit of thrombolytic therapy in acute ischemic stroke is time-dependent, a code stroke program needs to be implemented, maintained, and improved with continuous efforts to expedite thrombolytic therapy. We analyzed the long-term yield and efficiency of our code stroke program. Using a prospective single-center registry, we assessed the rates of stroke diagnosis and thrombolysis, door-to-CT scan and door-to-needle times, and annual trends in patients with code stroke activation between May 2007 and...

Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines-Stroke Registry.

Mild strokes have been poorly represented in thrombolytic trials and only a few series have reported outcomes after treatment with intravenous (IV) recombinant tissue plasminogen activator (rtPA) after mild stroke.



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