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    Correlation between biological characteristics of thrombus and short-term efficiency of thrombolytic therapy by acoustic radiation force impulse imaging technique.
    Int Angiol 2017 May 24. Epub 2017 May 24.
    Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
    Background: Evaluate the biological characteristics of lower extremity deep venous thrombosis by applying acoustic radiation force impulse imaging technique(ARFI), explore the correlation between the value of shear wave speed (SWV) and short-term efficacy of thrombolytic therapy as well as analyze the application value of shear wave velocity in predicting the short-term efficacy of thrombolytic therapy.

    Methods: Examine acoustic radiation force impulse imaging for 120 patients with lower extremity deep venous thrombosis and measure the shear wave velocity values. Analyze the thrombus SWV value among the cured group, effective treatment group and ineffective group according to the different effect of thrombolytic therapy and then classfy the cured and effective treatment group into total effective group, and compare the results of effetiveness and thrombus SWV. Read More

    Impact of perfusion lesion in corticospinal tract on response to reperfusion.
    Eur Radiol 2017 May 24. Epub 2017 May 24.
    Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, 88# Jiefang Road, Hangzhou, 310009, China.
    Objectives: We aimed to examine the impact of corticospinal tract (CST) involvement in acute ischaemic stroke (AIS) patients on functional outcome and the interaction with reperfusion.

    Methods: We retrospectively examined data in consecutive anterior circulation AIS patients undergoing thrombolysis. MR perfusion (time to maximum of tissue residue function, Tmax) and apparent diffusion coefficient (ADC) images were transformed into standard space and the volumes of CST involvement by Tmax > 6 s (CST-Tmax) and ADC < 620 × 10(-6) mm(2)/s (CST-ADC) lesions were calculated. Read More

    Regulatory T cells ameliorate tissue plasminogen activator-induced brain haemorrhage after stroke.
    Brain 2017 May 22. Epub 2017 May 22.
    Pittsburgh Institute of Brain Disorders and Recovery and Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
    Delayed thrombolytic treatment with recombinant tissue plasminogen activator (tPA) may exacerbate blood-brain barrier breakdown after ischaemic stroke and lead to lethal haemorrhagic transformation. The immune system is a dynamic modulator of stroke response, and excessive immune cell accumulation in the cerebral vasculature is associated with compromised integrity of the blood-brain barrier. We previously reported that regulatory T cells, which function to suppress excessive immune responses, ameliorated blood-brain barrier damage after cerebral ischaemia. Read More

    Effect of Pentoxifylline in Ameliorating Myocardial Injury in Patients With Myocardial Infarction Undergoing Thrombolytic Therapy: A Pilot Randomized Clinical Trial.
    J Clin Pharmacol 2017 May 17. Epub 2017 May 17.
    Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Cell death following acute myocardial infarction (MI) is the hallmark pathology of cardiovascular disease, leading to considerable mortality and morbidity. Platelet and neutrophil activation and inflammatory cytokines, prominently TNF-α, play an important role in the development of cell death. Because pentoxifylline inhibits platelet and neutrophil activation and reduces TNF-α, this study was performed to assess the potential benefit of pentoxifylline in the reduction of myocardial injury following acute MI. Read More

    ST-segment elevation myocardial infarction could be the primary presentation of acute aortic dissection.
    Am J Emerg Med 2017 May 11. Epub 2017 May 11.
    Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China. Electronic address:
    Background: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. Read More

    Systemic Thrombolytic Therapy and Catheter-directed Fragmentation with Local Thrombolytic Therapy in Patients with Pulmonary Embolism.
    Ann Vasc Surg 2017 May 10. Epub 2017 May 10.
    Academician E.N. Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology", Ministry for Public Health Care Russian Federation Novosibirsk, Russian Federation.
    The objective was to compare immediate and long-term results of systemic thrombolytic therapy (STT) and catheter-directed fragmentation (CDF) with local thrombolytic therapy (LTT) in patients with massive pulmonary embolism (PE).

    Methods: 209 patients with massive PE (the high risk of early death) were included in our study. From 2008 till 2010 in the first group (n=102) STT was performed. Read More

    Purification, biochemical, and structural characterization of a novel fibrinolytic enzyme from Mucor subtilissimus UCP 1262.
    Bioprocess Biosyst Eng 2017 May 12. Epub 2017 May 12.
    Department of Civil, Chemical and Environmental Engineering, Pole of Chemical Engineering, University of Genoa, via Opera Pia 15, 16145, Genoa, Italy.
    Fibrinolytic proteases are enzymes that degrade fibrin. They provide a promising alternative to existing drugs for thrombolytic therapy. A protease isolated from the filamentous fungus Mucor subtilissimus UCP 1262 was purified in three steps by ammonium sulfate fractionation, ion exchange, and molecular exclusion chromatographies, and characterized biochemically and structurally. Read More

    Ultrasound-assisted thrombolysis of an occluded transjugular portosystemic shunt.
    Diagn Interv Radiol 2017 May 12. Epub 2017 May 12.
    Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
    Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Read More

    Impact of coronary intensive care unit in treatment of myocardial infarction.
    Rev Assoc Med Bras (1992) 2017 Mar;63(3):242-247
    Assistant PhD Professor, Department of Internal Medicine, Faculdade de Medicina de Botucatu, Unesp, Botucatu, SP, Brazil.
    Introduction:: The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI) has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU). Read More

    Improved thrombolytic effect with focused ultrasound and neuroprotective agent against acute carotid artery thrombosis in rat.
    Sci Rep 2017 May 9;7(1):1638. Epub 2017 May 9.
    Departments of Electrical Engineering, Graduate Institute of Clinical Medical Sciences, Chang-Gung University, Taoyuan, 333, Taiwan.
    Combination therapy with focused ultrasound (FUS) and a neuroprotective agent, BNG-1, was examined in an acute carotid thrombotic occlusion model using LED irradiation in rat to improve the thrombolytic effect of rt-PA. Seven treatment groups included (A) intravenous bolus injection of 0.45 mg/kg rt-PA, (B) intravenous bolus injection of 0. Read More

    Blood-Brain Barrier Protection as a Therapeutic Strategy for Acute Ischemic Stroke.
    AAPS J 2017 May 8. Epub 2017 May 8.
    Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter, Amarillo, Texas, 79106, USA.
    The blood-brain barrier (BBB) is a vital component of the neurovascular unit (NVU) containing tight junctional (TJ) proteins and different ion and nutrient transporters which maintain normal brain physiology. BBB disruption is a major pathological hallmark in the course of ischemic stroke which is regulated by the actions of different factors working at different stages of cerebral ischemia including matrix metalloproteinases (MMPs), inflammatory modulators, vesicular trafficking, oxidative pathways, and junctional-cytoskeletal interactions. These components interact further to disrupt maintenance of both the paracellular and transport barriers of the central nervous system (CNS) to worsen ischemic brain injury and the propensity for hemorrhagic transformation (HT) associated with injury and/or thrombolytic therapy with tissue-type plasminogen activator (tPA). Read More

    Advanced Age and Higher National Institutes of Health Stroke Scale Score as Predictors of Poor Outcome in Ischemic Stroke Patients Treated with Alteplase: A Study from a Tertiary Care Centre in Rural North-west India.
    J Neurosci Rural Pract 2017 Apr-Jun;8(2):236-240
    Department of Neurology, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India.
    Introduction: Thrombolytic therapy in acute ischemic stroke has been approved for treatment of acute stroke for past two decades. However, identification of predictors of poor outcome after the intravenous (IV) alteplase therapy in acute stroke patients is a matter of research. The present study was conducted with the aim of identifying poor prognostic factors in patients of acute ischemic stroke patients. Read More

    Thrombolytic Therapy of Acute Massive Pulmonary Embolism using Swan-Ganz Pulmonary Artery Catheter.
    Ann Vasc Surg 2017 May 4. Epub 2017 May 4.
    Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; University Vascular Associates, Los Angeles, CA. Electronic address:
    Acute massive pulmonary embolism (PE) is associated with high fatality, and catheter-directed thrombolytic therapy has been shown to be an efficacious treatment for this condition. We herein report a patient who developed acute massive PE but could not undergo the conventional catheter-directed thrombolytic therapy. A Swan-Ganz pulmonary artery catheter was placed at bedside to initiate immediate thrombolytic infusion, which resulted in dramatic clinical improvement. Read More

    Systemic Thrombolysis in Acute Ischemic Stroke after Dabigatran Etexilate Reversal with Idarucizumab-A Case Report.
    J Stroke Cerebrovasc Dis 2017 May 4. Epub 2017 May 4.
    Neurovascular Center, Department of Neurology, Zealand University Hospital, Roskilde, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Introduction: Idarucizumab is a reversal agent for dabigatran etexilate. By reversing the anticoagulating effect of dabigatran etexilate with idarucizumab (Praxbind), patients presenting with an acute ischemic stroke can now be eligible for thrombolysis.

    Patient: We describe our experience with idarucizumab in a 71-year-old male patient pretreated with dabigatran etexilate. Read More

    ACR Appropriateness Criteria(®) Radiologic Management of Mesenteric Ischemia.
    J Am Coll Radiol 2017 May;14(5S):S266-S271
    Panel Chair, University of Chicago Hospital, Chicago, Illinois.
    Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Read More

    Catheter-Directed Thrombolysis of Acute Entire Limb Deep Vein Thrombosis From below the Knee Access: A Retrospective Analysis of a Single-Center Experience.
    Catheter Cardiovasc Interv 2017 May 4. Epub 2017 May 4.
    Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
    Purpose: To evaluate the safety and efficacy of below the knee (BTK) approach in the treatment of entire limb deep vein thrombosis (DVT).

    Materials And Methods: Retrospective analysis of consecutive CDT treatment of acute entire limb DVT using a BTK approach (September 2010-February 2016) was performed. The patients included 51 men and 28 women with a mean age of 54 years. Read More

    Aortic Aneurysm Rupture After Urokinase Treatment for Acute Limb Ischemia in Two Patients After EVAR.
    Cardiovasc Intervent Radiol 2017 May 3. Epub 2017 May 3.
    Department of Radiology, Haaglanden Medical Center, Lijnbaan 32, PO Box 432, 3000 CA, Den Haag, The Netherlands.
    Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. Read More

    Neuroprotective mechanisms and translational potential of therapeutic hypothermia in the treatment of ischemic stroke.
    Neural Regen Res 2017 Mar;12(3):341-350
    Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA; Veteran's Affair Medical Center, Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, USA.
    Stroke is a leading cause of disability and death, yet effective treatments for acute stroke has been very limited. Thus far, tissue plasminogen activator has been the only FDA-approved drug for thrombolytic treatment of ischemic stroke patients, yet its application is only applicable to less than 4-5% of stroke patients due to the narrow therapeutic window (< 4.5 hours after the onset of stroke) and the high risk of hemorrhagic transformation. Read More

    Effects of Ultraearly Intravenous Thrombolysis on Outcomes in Ischemic Stroke: The STEMO (Stroke Emergency Mobile) Group.
    Circulation 2017 May;135(18):1765-1767
    From Klinik und Hochschulambulanz für Neurologie (A.K., C.H.N., H.E., J.B.F., F.G., M.R., J.F.S., K.V., C.W., J.E.W., M.W., B.W., K.Z., M. Endres, M. Ebinger, H.J.A.), Center for Stroke Research Berlin (A.K., C.H.N., J.B.F., M.R., K.V., U.G., M. Endres, M. Ebinger, H.J.A.), German Center for Cardiovascular Research (DZHK), Berlin Partner Site (M. Endres), and German Center for Neurodegenerative Diseases (DZNE), Berlin Partner Site (M. Endres), Charité-Universitätsmedizin Berlin, Germany; Berliner Feuerwehr, Germany (S.K.); and Berlin Institute of Health, Germany (M. Endres).

    Acute pulmonary thromboembolism: Epidemiology, predictors, and long-term outcome - A single center experience.
    Indian Heart J 2017 Mar - Apr;69(2):160-164. Epub 2016 Oct 12.
    Department of Cardiology, MS Ramaiah Medical College, MS Ramaiah Memorial Hospital, Bangalore, Karnataka, India.
    Introduction: Acute pulmonary thromboembolism (PTE) is a life-threatening disease. Mortality in PTE still remains very high in spite of progress in diagnostic tools. Mortality rate is about 30% in patients with unrecognized acute PTE. Read More

    Dabigatran - metabolism, pharmacologic properties and drug interactions.
    Curr Drug Metab 2017 Apr 26. Epub 2017 Apr 26.
    Faculty of Pharmacy, University of Belgrade Belgrade. Serbia.
    The superiority of dabigatran has been well proven in the standard dosing regimen in prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) and extended venous thromboembolism (VTE) treatment. Dabigatran, an anticoagulant with a good safety profile, reduces intracranial bleeding in patients with atrial fibrillation and decreases major and clinically relevant non-major bleeding in acute VTE treatment. However, several important clinical issues are not fully covered by currently available directions with regard to dabigatran administration. Read More

    Tissue plasminogen activator; identifying major barriers related to intravenous injection in ischemic acute cerebral infraction.
    J Res Med Sci 2017 16;22:19. Epub 2017 Feb 16.
    Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
    Background: According to previous publications, in patients with acute ischemic cerebral infarction, thrombolytic therapy using intravenous tissue plasminogen activator (IV-tPA) necessitates precise documentation of symptoms' onset. The aim of this study was to identify major barriers related to the IV-tPA injection in such patients.

    Materials And Methods: Between the year 2014-2015, patients with definitive diagnosis of acute cerebral infarction (n = 180) who attended the neurology ward located at the Isfahan Alzahra Hospital were studied. Read More

    Bioprosthetic Valve Thrombosis.
    J Am Coll Cardiol 2017 May;69(17):2193-2211
    Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. Electronic address:
    Bioprosthetic valve (BPV) thrombosis is considered a relatively rare clinical entity. Yet a more recent analysis involving a more systematic echocardiographic follow-up, the advent of transcatheter heart valve (THV) technologies coupled with the highly sensitive nature of 4-dimensional computed tomographic imaging for detecting subclinical thrombi upon both surgically implanted and THVs, has generated enormous interest in this field, casting new light on both its true incidence and clinical relevance. Debate continues among clinicians as to both the clinical relevance of subclinical BPV thrombosis and the value of empirical oral anticoagulation following BPV implantation. Read More

    Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 2017.
    Int J Stroke 2017 Jan 1:1747493017706239. Epub 2017 Jan 1.
    24 University Health Network Stroke Program, Toronto, Ontario, Canada.
    Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services. Read More

    Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute ilio-femoral deep vein thrombosis: one-year follow-up data of a randomized-controlled trial.
    J Thromb Haemost 2017 Apr 25. Epub 2017 Apr 25.
    Clinic for Angiology, Swiss Cardiovascular Center, Bern University Hospital, University of Bern, Switzerland.
    Background: In patients with acute ilio-femoral deep vein thrombosis (IFDVT), catheter-directed thrombolysis (CDT) aims to prevent the post-thrombotic syndrome (PTS). Adding intravascular high-frequency, low-power ultrasound energy to CDT does not seem to improve the immediate thrombolysis results but its impact on clinical outcomes at 12 months is not known.

    Patients/methods: In this randomized-controlled trial, 48 patients (mean age 50±21 years, 52% women) with acute IFDVT were randomized to conventional CDT (n=24) or ultrasound-assisted CDT (USAT; n=24). Read More

    Outcome of acute ischemic stroke after intra-arterial thrombolysis: A study from India.
    Iran J Neurol 2016 Oct;15(4):195-201
    Department of Neurology AND Department of Research, Yashoda Hospital, Hyderabad, India.
    Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is the currently standard treatment of acute ischemic stroke within 4.5 hours of the onset of stroke. Recent studies have looked at the benefits of administration of intra-arterial (IA) rt-PA within 8 hours onset of symptoms. Read More

    Pulmonary alveolar hemorrhage following thrombolytic therapy.
    Int Med Case Rep J 2017 4;10:123-125. Epub 2017 Apr 4.
    Department of Medicine.
    We report a case of a 58-year-old male without any comorbidities who was thrombolysed with streptokinase for acute anterior wall myocardial infarction and developed massive hemoptysis with dyspnea and imaging features showing bilateral alveolar infiltrates. He was diagnosed with pulmonary alveolar hemorrhage and treated conservatively. His condition improved, and follow-up imaging showed resolution. Read More

    Sex differences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis - Insights from the Nationwide Inpatient Sample.
    Vasc Med 2017 Apr 17;22(2):128-134. Epub 2017 Mar 17.
    1 Division of Cardiovascular Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
    Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. Read More

    BET 1: A glass half full? Thrombolysis for the treatment of submassive pulmonary embolism.
    Emerg Med J 2017 May;34(5):331-334
    Salford Royal NHS Foundation Trust, Salford, UK
    A short-cut review was carried out to establish whether thrombolysis in addition to therapeutic anticoagulation could be of benefit in submassive (intermediate risk) pulmonary embolism (PE). 64 directly relevant papers were found using the reported search strategy. Of these, three presented the best evidence to answer the clinical question. Read More

    Comparison of antithrombotic agents during urgent percutaneous coronary intervention following thrombolytic therapy: A retrospective cohort study.
    Catheter Cardiovasc Interv 2017 Apr 18. Epub 2017 Apr 18.
    Division of Cardiology, Department of Internal Medicine, Baystate Medical Center, Tufts University, Springfield, MA, 01199.
    Background: The optimal antithrombotic regimen for urgent percutaneous coronary interventions (PCI) following thrombolytic therapy for ST segment myocardial infarction (STEMI) is currently unknown.

    Methods: We performed a retrospective analysis of all patients referred to our institution from January 2005 to July 2014 who underwent urgent PCI within 24 hr after receiving thrombolytic therapy. The patients were divided into three cohorts based on the anticoagulation strategy during PCI-bivalirudin, heparin alone or heparin plus Glycoprotein IIb/IIIa inhibitor (GPI). Read More

    Guided longer pulses from a diagnostic ultrasound and intraclot microbubble enhanced catheter-directed thrombolysis in vivo.
    J Thromb Thrombolysis 2017 Apr 17. Epub 2017 Apr 17.
    Internal Medicine Cardiology, University of Nebraska Medical Center, Omaha, NE, USA.
    The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process. Read More

    Septic Cerebral Venosinus Thrombosis Secondary to an Odontogenic Infection.
    J La State Med Soc 2017 Mar-Apr;169(2):33-36. Epub 2017 Apr 15.
    Baton Rouge General Medical Center.
    Background: Cerebral venosinus thrombosis (CVT); is an uncommon, potentially fatal disease that is more common in young adults and children. Thrombophilia, elevated estrogenic states, and infections are the most common risk factors in patients who develop CVT.

    Case: A 69-year-old man with a right-sided odontogenic infection presented with fever, headache, opthalmoplegia, and periorbital swelling. Read More

    Emerg Med Clin North Am 2017 May;35(2):281-299
    Department of Vascular Surgery, University Hospital Coventry and Warwickshire NHS Trust, Warwick Medical School and Coventry University, Coventry, UK.
    Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts the civilian population. The use of intravenous iloprost or intra-arterial thrombolytics has led to promising tissue salvage. Read More

    Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction.
    J Am Coll Cardiol 2017 Apr;69(15):1913-1920
    Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Medical Clinic II, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.
    Background: Mortality in cardiogenic shock (CS) remains high. Early risk stratification is crucial to make adequate treatment decisions.

    Objectives: This study sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with CS, derived from the IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock) trial. Read More

    Cytoprotective Drug-Tissue Plasminogen Activator Protease Interaction Assays: Screening of Two Novel Cytoprotective Chromones.
    Transl Stroke Res 2017 Apr 12. Epub 2017 Apr 12.
    Department of Neurology, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, Suite 8318, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.
    Tissue plasminogen activator (tPA) is currently used in combination with endovascular procedures to enhance recanalization and cerebral reperfusion and is also currently administered as standard-of-care thrombolytic therapy to patients within 3-4.5 h of an ischemic stroke. Since tPA is not neuroprotective or cytoprotective, adjuvant therapy with a neuroprotective or an optimized cytoprotective compound is required to provide the best care to stroke victims to maximally promote clinical recovery. Read More

    Percutaneous closure of post-myocardial infarction ventricular septal rupture - A single centre experience.
    Indian Heart J 2017 Apr 1;69 Suppl 1:S24-S27. Epub 2016 Nov 1.
    Krishna Institute of Medical Sciences, Hyderabad, India.
    Background: Post-infarction ventricular septal rupture (VSR) is a rare but lethal mechanical complication of an acute myocardial infarction (AMI). Survival to 1 month without intervention is 6%. Given high surgical mortality, transcatheter closure has emerged as a potential strategy in selected cases. Read More

    Collaborative Interventions Reduce Time-to-Thrombolysis for Acute Ischemic Stroke in a Public Safety Net Hospital.
    J Stroke Cerebrovasc Dis 2017 Apr 7. Epub 2017 Apr 7.
    Department of Neurology, University of California, San Francisco, San Francisco, California; Department of Neurology, Zuckerberg San Francisco General Hospital, San Francisco, California. Electronic address:
    Background And Purpose: Shorter time-to-thrombolysis in acute ischemic stroke (AIS) is associated with improved functional outcome and reduced morbidity. We evaluate the effect of several interventions to reduce time-to-thrombolysis at an urban, public safety net hospital.

    Methods: All patients treated with tissue plasminogen activator for AIS at our institution between 2008 and 2015 were included in a retrospective analysis of door-to-needle (DTN) time and associated factors. Read More

    [Application of percutaneous AngioJet thrombectomy in patients with acute symptomatic portal and superior mesenteric venous thrombosis].
    Zhonghua Yi Xue Za Zhi 2017 Apr;97(13):991-995
    Department of Interventional Radiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China.
    Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV). Read More

    [Mechanical and pharmacomechanical trombolysis in deep venous thrombosis with no clinical response to conventional treatment].
    Rev Med Chil 2017 Jan;145(1):63-71
    Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
    Background: Conventional treatment of deep vein thrombosis (DVT) is anticoagulation, bed rest and limb elevation. Proximal DVT patients with persisting edema, pain and cyanosis of extremities despite of conventional therapy may develop ischemia. Direct treatment of thrombosis becomes necessary. Read More

    Current and future perspectives on the treatment of cerebral ischemia.
    Expert Opin Pharmacother 2017 Apr;18(6):573-580
    a Department of Neurological Surgery , Columbia University Medical Center , New York , NY , USA.
    Introduction: After heart disease and combined forms of cancer, stroke is the leading cause of death in the United States. Currently, tissue-plasminogen activator (tPA) thrombolysis is the only thrombolytic therapy that has been shown to improve patient outcome. Presently, the only antithrombotic drug treatment that has proven effective at improving acute ischemic stroke patient outcome is aspirin administration. Read More

    Bifurcation in Blood Oscillatory Rhythms for Patients with Ischemic Stroke: A Small Scale Clinical Trial using Laser Doppler Flowmetry and Computational Modeling of Vasomotion.
    Front Physiol 2017 23;8:160. Epub 2017 Mar 23.
    Optoelectronics and Biomedical Photonics Group, Photonics and Nanoscience Group, Aston Institute of Photonic Technologies, Aston University Birmingham, UK.
    We describe application of spectral analysis of laser Doppler flowmetry (LDF) signals to investigation of cerebrovascular haemodynamics in patients with post-acute ischemic stroke (AIS) and cerebrovascular insufficiency. LDF was performed from 3 to 7 days after the onset of AIS on forehead in the right and left supraorbital regions in patients. Analysis of LDF signals showed that perfusion in the microvasculature in AIS patients was lower than that in patients with cerebrovascular insufficiency. Read More

    Vascular closure devices in stroke patients receiving tissue plasminogen activator: A retrospective analysis from an academic tertiary medical center and a teaching community hospital stroke database.
    Clin Neurol Neurosurg 2017 Jun 29;157:22-24. Epub 2017 Mar 29.
    The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, United States; Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, United States; Department of Diagnostic Imaging, Miriam Hospital, 164 Summit Ave, Providence, RI 02906, United States.
    Objectives: To determine the safety and effectiveness of vascular closure devices in prevention of access site complications in acute stroke patient receiving intravenous (IV) and/or intra-arterial (IA) IV tissue plasminogen activator (tPA).

    Patients And Methods: All patients with acute stroke onset treated with IV and/or IA tPA closed with vascular closure device and adult age (>18 years) were identified from an academic tertiary medical center and a teaching community hospital stroke database for 9 years (from March 2005 to June 2014).

    Results: A total of 69 patients were included in the study. Read More

    Parkinsonism or Other Movement Disorders Presenting as Stroke Mimics.
    Acta Neurol Taiwan 2016 Dec;25(4):124-128
    Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Purpose: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. Read More

    Edaravone-Encapsulated Agonistic Micelles Rescue Ischemic Brain Tissue by Tuning Blood-Brain Barrier Permeability.
    Theranostics 2017 8;7(4):884-898. Epub 2017 Feb 8.
    Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, 826 Zhangheng Road, Shanghai 201203, P. R. China.
    Thrombolysis has been a standard treatment for ischemic stroke. However, only 2-7% patients benefit from it because the thrombolytic agent has to be injected within 4.5 h after the onset of symptoms to avoid the increasing risk of intracerebral hemorrhage. Read More

    Thromboelastometric analysis of the risk factors for return of spontaneous circulation in adult patients with out-of-hospital cardiac arrest.
    PLoS One 2017 5;12(4):e0175257. Epub 2017 Apr 5.
    Division of Trauma Surgery and Surgical Critical Care, Faculty of Medicine, Saga University, Saga, Japan.
    It is well known that coagulopathy is observed in patients with out-of-hospital cardiac arrest (OHCA). Thrombolytic therapy for those patients has been controversial until now. The purpose of this study was to identify a significant predictor for return of spontaneous circulation (ROSC) of OHCA patients in the emergency department (ED) using whole blood viscoelastic testing. Read More

    New thrombolytic strategy providing neuroprotection in experimental ischemic stroke: MMP10 alone or in combination with tPA.
    Cardiovasc Res 2017 Apr 3. Epub 2017 Apr 3.
    Laboratory of Atherothrombosis, Program of Cardiovascular Diseases, CIMA-University of Navarra, IdiSNA. Pamplona, Spain. CIBERCV.
    Aim: Considering that MMP-10 improves stroke injury, we have examined the therapeutic and protective effect of MMP10 and tPA/MMP10 as clot-dissolving and neuroprotective agent in an experimental model of ischemic stroke and studied in vitro the molecular pathways involved in MMP10-mediated effects.

    Methods And Results: Cerebral ischemia was induced by the local injection of thrombin into the middle cerebral artery followed by reperfusion with MMP10 (6.5µg/Kg) and tPA (10mg/Kg) alone or in combination with MMP10. Read More

    Interactions between iodinated contrast media and tissue plasminogen activator:In vitro comparison study.
    Clin Hemorheol Microcirc 2017 Mar 30. Epub 2017 Mar 30.
    Department of Radiology, University of Pecs Medical School, Pecs, Hungary.
    Background And Purpose: Iodinated contrast media (Xenetix®, Ultravist®, Omnipaque®, Visipaque® and Iomeron®) used for computed tomography (CT) may decrease fibrinolysis by recombinant tissue plasminogen activator (rt-PA). We hypothesized that receiving iodinated contrast media before rt-PA may impair thrombolysis as measured by a new model system.

    Methods: Whole blood from Wistar Kyoto rats (n = 10) was obtained and allowed to form blood clots. Read More

    Intervention radiology for venous thrombosis: early thrombus removal using invasive methods.
    Br J Haematol 2017 Apr 2;177(2):173-184. Epub 2017 Apr 2.
    Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA.
    The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Read More

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