32,204 results match your criteria Thrombolytic Therapy


Serial Point-of-care Echocardiography Performed by an Emergency Physician to Guide Thrombolytic Management of Massive Pulmonary Embolism.

Cureus 2020 Apr 21;12(4):e7771. Epub 2020 Apr 21.

Emergency Medicine, Hospital Corporation of America West Florida GME Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA.

Massive pulmonary embolism (PE) is a life-threatening condition with a high mortality burden. The rapid diagnosis of PE can be supported with focused cardiac ultrasound (FOCUS) by identifying signs of right ventricular dysfunction (RVD). This case report describes a patient with hemodynamically unstable massive PE who received systemic thrombolytic therapy. Read More

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http://dx.doi.org/10.7759/cureus.7771DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243659PMC

Acute ischemic stroke management in Lebanon: obstacles and solutions.

Funct Neurol 2019 Jul/Sep;34(3):167-176

Management of acute stroke varies greatly within and between different countries. This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Read More

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Endovascular mechanical thrombectomy versus thrombolysis in patients with iliofemoral deep vein thrombosis - a systematic review and meta-analysis.

Vasa 2020 May 25:1-9. Epub 2020 May 25.

Health Economics and Healthcare Management Division, Kozminski University, Warsaw, Poland.

This study sought to compare effectiveness and safety of percutaneous mechanical thrombectomy (PMT) and thrombolysis alone (THR) in patients with acute or subacute iliofemoral deep vein thrombosis (IfDVT). Observational and randomized trials, published between January 2001 to February 2019 were identified by searching MEDLINE. Studies on deep venous thrombosis (DVT) treated with either THR or PMT adjunctive to conventional anticoagulation and compressive intervention were included. Read More

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http://dx.doi.org/10.1024/0301-1526/a000875DOI Listing

Endovascular approach for acute limb ischemia without thrombolytic therapy.

Ther Adv Cardiovasc Dis 2020 Jan-Dec;14:1753944720924575

Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada City, Osaka, Japan.

Background: Endovascular therapy for acute lower limb ischemia (ALLI) has developed and demonstrated safety and efficacy. The purpose of this study was to assess clinical outcomes in patients treated for ALLI with conventional endovascular or surgical revascularization.

Method: This study was a retrospective single-center review. Read More

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http://dx.doi.org/10.1177/1753944720924575DOI Listing

Expansion of the dimensions in the current management of acute ischemic stroke.

J Neurol 2020 May 20. Epub 2020 May 20.

Department of Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Stroke is the fifth leading cause of death in the United States with a huge burden on health care. Acute ischemic stroke (AIS) accounts for 87% of all stroke. The use of thrombolytic agents in AIS treatment is well known since 1950 but no FDA approval until 1996, due to lack of strong evidence showing benefits outweigh the risk of intracranial hemorrhage. Read More

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http://dx.doi.org/10.1007/s00415-020-09873-6DOI Listing

Successful Fibrinolytic Therapy in a Challenging Obstructive Prosthetic Mitral Valve Thrombosis.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620921078

Creighton University, Omaha, NE, USA.

Prosthetic valve thrombosis is a rare and severe complication of the mechanical prosthetic valve. Management can be challenging due to varying clinical presentation, overlapping features of differential diagnosis, and lack of randomized controlled trials on the therapeutic options. In this article, we report the case of a patient with a mechanical prosthetic mitral valve presented with symptoms of heart failure, and an echocardiography showing increased mean pressure gradient across the prosthesis along with a fixed posterior leaflet and a partially restricted anterior leaflet with no visible mass. Read More

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http://dx.doi.org/10.1177/2324709620921078DOI Listing

Removal of Peripheral Arterial Occlusive Material with the Rotarex® S Device: Mechanical Atherothrombectomy.

Authors:
Miroslav Bulvas

Surg Technol Int 2020 May;36:225-232

Charles University Prague, Third School of Medicine, University Hospital Královské Vinohrady, Department of Surgery and Division of Interventional Angiology, Prague, Czech Republic.

Mechanical atherothrombectomy (MATH) with the Rotarex® S (Straub Medical AG, Wangs, Switzerland) catheter is an endovascular therapeutic technique for removing fragmentable occlusive material from the lumen of peripheral vessels. It can be used as a rapid, safe and efficacious initial modality for the treatment of acute or subacute ischemia of the lower limbs, even in patients with an immediately threatened extremity and those with a contraindication for surgical and/or thrombolytic therapy. Patient placement in an intensive care unit and routine embolic prevention with a filter are not necessary. Read More

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Bioinspired Soft Microrobots with Precise Magneto-Collective Control for Microvascular Thrombolysis.

Adv Mater 2020 May 20:e2000366. Epub 2020 May 20.

School of Electronics and Information Engineering, Tongji University, 4800 Caoan Road, Shanghai, 201804, China.

New-era soft microrobots for biomedical applications need to mimic the essential structures and collective functions of creatures from nature. Biocompatible interfaces, intelligent functionalities, and precise locomotion control in a collective manner are the key parameters to design soft microrobots for the complex bio-environment. In this work, a biomimetic magnetic microrobot (BMM) inspired by magnetotactic bacteria (MTB) with speedy motion response and accurate positioning is developed for targeted thrombolysis. Read More

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http://dx.doi.org/10.1002/adma.202000366DOI Listing

Factors Associated with Pre-Hospital Delay and Intravenous Thrombolysis in China.

J Stroke Cerebrovasc Dis 2020 May 16:104897. Epub 2020 May 16.

Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address:

Background: Pre-hospital delay was a critical factor affecting stroke patients receiving intravenous thrombolytic therapy. The aim of this study was to explore the factors associated with pre-hospital delay and thrombolysis in China.

Methods: Patient data were obtained from emergency department (ED), and the factors of patient pre-hospital delay were recorded through a well-designed form. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104897DOI Listing

Ischemic stroke with a preceding Trans ischemic attack (TIA) less than 24 hours and thrombolytic therapy.

BMC Neurol 2020 May 19;20(1):197. Epub 2020 May 19.

University of South Carolina School of Medicine Greenville, 607 Grove Rd, Greenville, SC, 29605, USA.

Background: Acute ischemic stroke attack with and without a recent TIA may differ in clinical risk factors, and this may affect treatment outcomes following thrombolytic therapy. We examined whether the odds of exclusion or inclusion for thrombolytic therapy are greater in ischemic stroke with TIA less than 24 h preceding ischemic stroke (recent-TIA) as compared to those without recent TIA or non-TIA > 24 h and less than 1 month (past-TIA).

Methods: A retrospective hospital-based analysis was conducted on 6315 ischemic stroke patients, of whom 846 had proven brain diffusion-weighted magnetic resonance imaging (DW-MRI) of an antecedent TIA within 24 h prior to ischemic stroke. Read More

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http://dx.doi.org/10.1186/s12883-020-01782-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236928PMC

Early Outcomes with Utilization of Tissue Plasminogen Activator in COVID-19 Associated Respiratory Distress: A series of five cases.

J Trauma Acute Care Surg 2020 May 21. Epub 2020 May 21.

Department of Trauma/Critical Care, The Medical Center Navicent Health and Mercer University School of Medicine, Macon, GA.

Background: Coronavirus patients demonstrate varying degrees of respiratory insufficiency; many will progress to respiratory failure with a severe version of acute respiratory distress syndrome (ARDS) refractory to traditional supportive strategies. Providers must consider alternative therapies to deter or prevent the cascade of decompensation to fulminant respiratory failure.

Methods: This is a case-series of five COVID-19 positive patients who demonstrated severe hypoxemia, declining respiratory performance, and escalating oxygen requirements. Read More

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http://dx.doi.org/10.1097/TA.0000000000002787DOI Listing

A Successful Quality Improvement Project for Detection and Management of Acute Stroke in Hospitalized Patients.

J Neurosci Nurs 2020 May 14. Epub 2020 May 14.

Questions or comments about this article may be directed to Carol J. Droegemueller, MS APRN CNS OCNS CNRN, at C.J.D. is Stroke Program Coordinator, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Bhavani Kashyap, PhD MBBS, is Research Associate, HealthPartners Neuroscience Center, HealthPartners Institute, Bloomington, MN. Roberta L. Huna Wagner, DNP APRN CNS AGCNS-BC PCCN, is Clinical Nurse Specialist, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Hannah Shibeshi, BAN RN CNRN CCRN, is Registered Nurse, Regions Hospital Comprehensive Stroke Center, St Paul, MN. Mitchell W. Clayton, BS, is Student Intern, HealthPartners Neuroscience Center, St Paul, MN. Mary W. Fennig, BA, is Student Intern, HealthPartners Neuroscience Center, St Paul, MN. Haitham M. Hussein, MD MSc FAHA FAAN, is Medical Director, Regions Hospital Comprehensive Stroke Center, HealthPartners Neuroscience Center, HealthPartners Institute, Bloomington, MN.

Background: The incidence rate of stroke in hospitalized patients ranges between 2% and 17% of all strokes-a higher rate than in the community. Delays in recognition and management of stroke in hospitalized patients lead to worse outcomes. At our hospital, the existing in-hospital stroke (IHS) code showed low usage and effectiveness. Read More

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http://dx.doi.org/10.1097/JNN.0000000000000517DOI Listing

Could HIF-1? be a novel biomarker for the clinical course and treatment of pulmonary embolism?

Turk J Med Sci 2020 May 18. Epub 2020 May 18.

Background And Aim: Pulmonary embolism (PE) is associated with high morbidity and mortality rates if not diagnosed and treated rapidly. The aim of our study was to investigate the relationship between levels of hypoxia-induced factor-1 alpha (HIF-1?) and clinical course and prognosis in patients with intermediate low-risk , intermediate high-risk, and high risk PE.

Materials And Methods: The study included 240 subjects in 4 groups: a healthy control group (n = 60, mean age = 60 ± 15. Read More

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http://dx.doi.org/10.3906/sag-1908-93DOI Listing

Reappraising Thrombolytic Therapy and Risk Stratification for Acute Pulmonary Embolism: Where Does Hypoxemia Fit In?

Authors:
Rajesh Gupta

Am J Med Sci 2020 Apr 26. Epub 2020 Apr 26.

Division of Cardiovascular Medicine, University of Toledo, Toledo, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.amjms.2020.04.027DOI Listing

Effects of protective controlled coronary reperfusion on left ventricular remodeling in dogs with acute myocardial infarction: A pilot study.

Cardiovasc Revasc Med 2020 May 6. Epub 2020 May 6.

InVatin Technologies, Ltd., Kazrin, Israel; Applicative Cardiovascular Research Center (ACRC) and Department of Cardiology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:

Background: Coronary artery obstruction causes ischemia of cardiac tissue, leading to acute myocardial infarction (AMI). The treatment of choice for reducing acute myocardial ischemic injury is early, effective vascular reperfusion using thrombolytic therapy or primary percutaneous coronary intervention. However, reperfusion can cause cardiomyocyte injury. Read More

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http://dx.doi.org/10.1016/j.carrev.2020.05.001DOI Listing

Use of Tissue Plasminogen Activator as a Surrogate Measure for Central Venous Catheter Dysfunction and Survival Outcome in Children with Cancer: A Population-Based Retrospective Cohort Study.

Pediatr Hematol Oncol 2020 May 15:1-7. Epub 2020 May 15.

Department of Pediatrics, Division of Hematology/Oncology, IWK Health Centre, Halifax, Canada.

Central venous catheter (CVC) dysfunction is often associated with thrombosis, which in turn has been linked with poorer survival outcomes in cancer patients. Our objective was to examine the association of tissue plasminogen activator (tPA) administration as a surrogate measure of CVC dysfunction with survival in pediatric cancer patients. The present study uses data from a population-based retrospective cohort of pediatric oncology patients from the Canadian Maritime provinces treated between 2000 and 2017 at the IWK Health Centre, Halifax, NS. Read More

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http://dx.doi.org/10.1080/08880018.2020.1762810DOI Listing

How to manage catheter-related right atrial thrombosis: Our conservative approach.

J Vasc Access 2020 May 15:1129729820922703. Epub 2020 May 15.

Department of Nephrology, "F.Miulli" General Hospital, Acquaviva delle Fonti, Italy.

Background: Catheter-related right atrial thrombosis is an underestimated, severe, and life-threatening complication of any type of central venous catheters. No clear-cut epidemiological data are available. Catheter-related right atrial thrombosis is often asymptomatic; however, it can lead to serious complications and death. Read More

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http://dx.doi.org/10.1177/1129729820922703DOI Listing

Low-Frequency Vibrations Enhance Thrombolytic Therapy and Improve Stroke Outcomes.

Stroke 2020 Jun 13;51(6):1855-1861. Epub 2020 May 13.

Department of Neurology, Carver College of Medicine (E.C.L.), University of Iowa.

Background and Purpose- We aim to determine the potential impact on stroke thrombolysis of drip-and-ship helicopter flights and specifically of their low-frequency vibrations (LFVs). Methods- Mice with a middle cerebral artery autologous thromboembolic occlusion were randomized to receive rtPA (recombinant tissue-type plasminogen activator; or saline) 90 minutes later in 3 different settings: (1) a motion platform simulator that reproduced the LFV signature of the helicopter, (2) a standardized actual helicopter flight, and (3) a ground control. Results- Mice assigned to the LFV simulation while receiving tPA had smaller infarctions (31. Read More

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http://dx.doi.org/10.1161/STROKEAHA.120.029405DOI Listing
June 2020
5.723 Impact Factor

Erythrocytes as Carriers of Therapeutic Enzymes.

Authors:
Bridget E Bax

Pharmaceutics 2020 May 8;12(5). Epub 2020 May 8.

Molecular and Clinical Sciences, St. George's, University of London, London SW17 0RE, UK.

Therapeutic enzymes are administered for the treatment of a wide variety of diseases. They exert their effects through binding with a high affinity and specificity to disease-causing substrates to catalyze their conversion to a non-noxious product, to induce an advantageous physiological change. However, the metabolic and clinical efficacies of parenterally or intramuscularly administered therapeutic enzymes are very often limited by short circulatory half-lives and hypersensitive and immunogenic reactions. Read More

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http://dx.doi.org/10.3390/pharmaceutics12050435DOI Listing

Successful Treatment of Acute Limb Ischemia Secondary to Iatrogenic Distal Embolization Using Catheter Directed Aspiration Thrombectomy.

Front Surg 2020 23;7:22. Epub 2020 Apr 23.

Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, United States.

Acute limb ischemia (ALI) due to thromboembolism is a limb- and life-threatening condition regularly encountered by vascular surgeons. Iatrogenic distal embolization is occasionally seen as a complication of various endovascular procedures. We present a series of four patients who developed ALI due to arterial embolization during cardiovascular procedures that were successfully treated via catheter directed aspiration embolectomy. Read More

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http://dx.doi.org/10.3389/fsurg.2020.00022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192036PMC

Impact of certain public health factors on the duration of inpatient treatment of mi patients.

Wiad Lek 2020 ;73(5):850-856

I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Objective: The aim was to study the impact of predictors on the duration of inpatient treatment of MI patients.

Patients And Methods: Materials and methods: We copied data of 462 inpatient medical records of myocardial infarction patients who underwent hospital treatment by different methods (coronary artery stenting, thrombolytic therapy, conventional drug therapy). We determined basic predictors and duration of inpatient treatment of MI patients. Read More

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January 2020

Complete Cognitive Recovery and Survival From Massive Pulmonary Embolism During General Anesthesia after Administration of Alteplase: A Case Report.

P R Health Sci J 2020 Mar;39(1):62-63

Department of Anesthesiology, University of Puerto Rico Medical Sciences Campus, San Juan, PR.

Presented herein is the case of a 37-year-old male who was scheduled for an anterior decompressive laminectomy after suffering trauma to the cervical area (C6-C7). An intraoperative acute pulmonary embolism (APE) was suspected after persistent hypoxemia and a decreased end-tidal CO2 that was refractory to proper management. After 6 intraoperative episodes of cardiac arrest that followed, intravenous alteplase (thrombolytic therapy) was administered, and the patient was stabilized without major complications. Read More

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[Consensus of Chinese experts on diagnosis and treatment processes of acute myocardial infarction in the context of prevention and control of COVID-19 (first edition)].

Nan Fang Yi Ke Da Xue Xue Bao 2020 Feb;40(2):147-151

College of Cardiovascular Physicians, Chinese Medical Association, Shanghai 200032, China.

The SARS-CoV-2 epidemic starting in Wuhan in December, 2019 has spread rapidly throughout the nation. The control measures to contain the epidemic also produced influences on the transport and treatment process of patients with acute myocardial infarction (AMI), and adjustments in the management of the patients need to be made at this particular time. AMI is characterized by an acute onset with potentially fatal consequence, a short optimal treatment window, and frequent complications including respiratory infections and respiratory and circulatory failure, for which active on-site treatment is essential. Read More

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http://dx.doi.org/10.12122/j.issn.1673-4254.2020.02.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086133PMC
February 2020

Cholesterol reducer and thrombolytic therapy in acute ischemic stroke patients.

Lipids Health Dis 2020 May 6;19(1):84. Epub 2020 May 6.

University of South Carolina School of Medicine Greenville, 607 Grove Rd, Greenville, SC, 29605, USA.

Background: Specific clinical risk factors may contribute to improving or worsening neurological functions in acute ischemic stroke (AIS) patients pre-treated with a combined cholesterol reducer and recombinant tissue plasminogen activator (rtPA) therapy. In this study, clinical risk factors associated with good or poor presenting neurological symptoms in ischemic stroke patients with prior cholesterol reducer use, specifically a statin and rtPA therapy was investigated.

Methods: Retrospective data for baseline clinical and demographic data for patients with AIS taking cholesterol reducers prior to rtPA treatment from January 2010 to June 2016 in a regional stroke center was analyzed. Read More

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http://dx.doi.org/10.1186/s12944-020-01270-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201805PMC

Thrombolysis before Thrombectomy - To Be or DIRECT-MT?

Authors:
Gregory W Albers

N Engl J Med 2020 05 6;382(21):2045-2046. Epub 2020 May 6.

From the Stanford Stroke Center, Palo Alto, CA.

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http://dx.doi.org/10.1056/NEJMe2004550DOI Listing

Pulmonary intravascular coagulation in COVID-19: possible pathogenesis and recommendations on anticoagulant/thrombolytic therapy.

J Thromb Thrombolysis 2020 May 5. Epub 2020 May 5.

Department of Paediatric Haemotology and Oncology, Faculty of Medicine, Baskent University, Sehit Temel Kuguluoglu Str. No:24, Bahcelievler, Ankara, Turkey.

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http://dx.doi.org/10.1007/s11239-020-02129-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200048PMC

Effects of Baseline Systolic Blood Pressure on Outcome in Ischemic Stroke Patients With Intravenous Thrombolysis Therapy: A Systematic Review and Meta-Analysis.

Neurologist 2020 May;25(3):62-69

Department of Neurology, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen.

Background: Baseline systolic blood pressure (SBP) is an important parameter that can significantly influence the outcome in ischemic stroke patients who received intravenous thrombolysis, but the target baseline SBP for optimal outcome is uncertain. This study aimed to assess the relationship between baseline SBP and outcome.

Materials And Methods: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000267DOI Listing

Biomaterials to Neuroprotect the Stroke Brain: A Large Opportunity for Narrow Time Windows.

Cells 2020 Apr 26;9(5). Epub 2020 Apr 26.

Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain.

Ischemic stroke represents one of the most prevalent pathologies in humans and is a leading cause of death and disability. Anti-thrombolytic therapy with tissue plasminogen activator (t-PA) and surgical thrombectomy are the primary treatments to recanalize occluded vessels and normalize the blood flow in ischemic and peri-ischemic regions. A large majority of stroke patients are refractory to treatment or are not eligible due to the narrow time window of therapeutic efficacy. Read More

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http://dx.doi.org/10.3390/cells9051074DOI Listing

Prediction model based on blood urea nitrogen and the leukocyte count for intestinal necrosis in patients with portal vein system thrombosis: a retrospective study.

Ann Transl Med 2020 Mar;8(6):326

Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Background: Portal vein system thrombosis (PVST) is a serious and potentially fatal disease. No definite parameter can predict intestinal necrosis in patients with PVST to justify early surgical intervention. The current study aimed to explore a simple and accurate model to predict the occurrence of intestinal necrosis in patients with PVST. Read More

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http://dx.doi.org/10.21037/atm.2020.02.108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186628PMC

Changing the strategy and culture of stroke awareness education in China: implementing Stroke 1-2-0.

Stroke Vasc Neurol 2020 Apr 28. Epub 2020 Apr 28.

Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

This project implemented the Stroke 1-2-0 stroke awareness programme across China and investigated its impact over a 2-year period. We initiated the Stroke 1-2-0 educational campaign and Stroke 1-2-0 special task forces (STF) across the nation. Massive media coverage, community-based educational sessions with videos and other related materials and induction of Stroke 1-2-0 STF were the major means of promotion. Read More

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http://dx.doi.org/10.1136/svn-2019-000324DOI Listing

Limited Efficacy of Thrombolytics for Pump Thrombosis in Durable Left Ventricular Assist Devices.

Ann Thorac Surg 2020 Apr 26. Epub 2020 Apr 26.

Division of Cardiac Surgery,; Heart and Vascular Institute,. Electronic address:

Background: This study reports a single center experience with thrombolytics for left ventricular assist device (LVAD) pump thrombosis.

Methods: Adults undergoing continuous-flow LVAD implantation between 2004-2018 at a single center were reviewed and those with pump thrombosis identified. Primary outcomes included 1-year survival and success rates of thrombolytic therapy. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.03.061DOI Listing

Messenger RNA/polymeric carrier nanoparticles for delivery of heme oxygenase-1 gene in the post-ischemic brain.

Biomater Sci 2020 Apr 29. Epub 2020 Apr 29.

Department of Bioengineering, College of Engineering, Hanyang University, Seoul, 04763, Korea.

Ischemic stroke is a cerebrovascular disease caused by narrowed cerebral arteries. Thrombolytic agents such as tissue-plasminogen activators have been used for recanalization of the blood supply into the ischemic region. However, ischemia-reperfusion damage continues to increase the infarction volume. Read More

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http://dx.doi.org/10.1039/d0bm00076kDOI Listing

Thrombolysis in massive and submassive pulmonary embolism during pregnancy and the puerperium: a systematic review.

J Thromb Thrombolysis 2020 Apr 28. Epub 2020 Apr 28.

Escuela de Medicina y Ciencias de La Salud, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico.

Thrombolysis in high-risk pulmonary embolism (PE) patients is recommended worldwide; however, the evidence for thrombolysis during pregnancy and the immediate puerperium remains unclear. We conducted a systematic review from 1950 to 2019 through PubMed, Ovid/Willey, and Cochrane Library to assess the safety and effectiveness of thrombolysis during pregnancy and the immediate puerperium. Additionally, we characterized the clinical presentation, risk stratification, and diagnostic approach. Read More

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http://dx.doi.org/10.1007/s11239-020-02122-7DOI Listing

Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates.

Burns Trauma 2020 10;8:tkaa008. Epub 2020 Apr 10.

Department of Surgery, Maine Medical Center, 22 Bramhall St, Portland, Maine 04102, USA.

Background: Frostbite is a cold injury that has the potential to cause considerable morbidity and long-term disability. Despite the complexity of these patients, diagnostic and treatment practices lack standardization. Thrombolytic therapy has emerged as a promising treatment modality, demonstrating impressive digit salvage rates. Read More

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http://dx.doi.org/10.1093/burnst/tkaa008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175769PMC

Outcomes of catheter-directed versus systemic thrombolysis for the treatment of pulmonary embolism: A real-world analysis of national administrative claims.

Vasc Med 2020 Apr 27:1358863X20903371. Epub 2020 Apr 27.

Department of Medicine, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Catheter-directed thrombolysis (CDT) and systemic thrombolysis (ST) are used to treat intermediate/high-risk pulmonary embolism (PE) in the absence of comparative safety and effectiveness data. We utilized a large administrative database to perform a comparative safety and effectiveness analysis of catheter-directed versus systemic thrombolysis. From the Optum Clinformatics Data Mart private-payer insurance claims database, we identified 100,744 patients hospitalized with PE between 2004 and 2014. Read More

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http://dx.doi.org/10.1177/1358863X20903371DOI Listing

Successful Percutaneous Transcatheter Closure of a Common Femoral Artery Pseudoaneurysm With Use of MicroVascular Plug Despite Continued Catheter-Directed Thrombolysis.

Vasc Endovascular Surg 2020 Apr 26:1538574420921276. Epub 2020 Apr 26.

Division of Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA.

Common femoral artery pseudoaneurysm is a known complication of percutaneous vascular access. Treatment options include surgical repair of the pseudoaneurysm or endovascular methods such as ultrasound-guided compression and direct thrombin injection into the pseudoaneurysm sac. Treatment of pseudoaneurysm is more challenging when a patient is undergoing concurrent catheter-directed or systemic thrombolytic therapy. Read More

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http://dx.doi.org/10.1177/1538574420921276DOI Listing

Catheter directed thrombolytic therapy and aspiration thrombectomy in intermediate pulmonary embolism with long term results.

Cardiol J 2020 Apr 24. Epub 2020 Apr 24.

Cardiac and Vascular Center, Semmelweis University, Városmajor str 68, 1122 Budapest, Hungary.

Background: Catheter directed thrombolysis (CDT) and thrombectomy represent well established techniques for the treatment of intermediate pulmonary embolism (IPE). The long-term effect of catheter directed thrombolysis of IPE is unknown.

Methods: Clinical, interventional and echocardiographic data from 80 consecutive patients with IPE who were treated with CDT were evaluated. Read More

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http://dx.doi.org/10.5603/CJ.a2020.0060DOI Listing

Management of ST-segment-elevation myocardial infarction during the coronavirus disease 2019 (COVID-19) outbreak: Iranian"247" National Committee's position paper on primary percutaneous coronary intervention.

Catheter Cardiovasc Interv 2020 Apr 22. Epub 2020 Apr 22.

Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

World Health Organization has designated coronavirus disease 2019 (COVID-19) as a pandemic. During the past several weeks, a considerable burden has been imposed on the Iranian's healthcare system. The present document reviewed the latest evidence and expert opinion regarding the management of ST-segment-elevation myocardial infarction during the outbreak of COVID-19 and outlines a practical algorithm for it. Read More

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http://dx.doi.org/10.1002/ccd.28889DOI Listing
April 2020
2.107 Impact Factor

[Acute stroke treatment in old age].

Authors:
Frank Erbguth

Med Klin Intensivmed Notfmed 2020 May;115(4):351-366

Universitätsklinik für Neurologie, Klinikum Nürnberg Süd, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland.

In patients over 80 years old, 4 of the 5 evidence-based acute treatments of ischemic stroke, i.e. stroke unit treatment, antiplatelet therapy, intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are effective but with a higher morbidity than in younger patients. Read More

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http://dx.doi.org/10.1007/s00063-020-00684-1DOI Listing

Optimized mouse model of embolic MCAO: From cerebral blood flow to neurological outcomes.

J Cereb Blood Flow Metab 2020 Apr 20:271678X20917625. Epub 2020 Apr 20.

Pittsburgh Institute of Brain Disorders & Recovery and UPMC Stroke Institute, Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

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http://dx.doi.org/10.1177/0271678X20917625DOI Listing

Letter by Nicholson et al Regarding Article, "Thrombolytic Therapy for Acute Central Retinal Artery Occlusion".

Stroke 2020 May 17;51(5):e95. Epub 2020 Apr 17.

Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Canada.

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http://dx.doi.org/10.1161/STROKEAHA.120.029552DOI Listing

Response by Mac Grory et al to Letter Regarding Article, "Thrombolytic Therapy for Acute Central Retinal Artery Occlusion".

Stroke 2020 May 17;51(5):e96. Epub 2020 Apr 17.

Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN.

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http://dx.doi.org/10.1161/STROKEAHA.120.029609DOI Listing

Preparation of Peptide and Recombinant Tissue Plasminogen Activator Conjugated Poly(Lactic-Co-Glycolic Acid) (PLGA) Magnetic Nanoparticles for Dual Targeted Thrombolytic Therapy.

Int J Mol Sci 2020 Apr 13;21(8). Epub 2020 Apr 13.

Department of Chemical and Materials and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.

Recombinant tissue plasminogen activator (rtPA) is the only thrombolytic agent that has been approved by the FDA for treatment of ischemic stroke. However, a high dose intravenous infusion is required to maintain effective drug concentration, owing to the short half-life of the thrombolytic drug, whereas a momentous limitation is the risk of bleeding. We envision a dual targeted strategy for rtPA delivery will be feasible to minimize the required dose of rtPA for treatment. Read More

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http://dx.doi.org/10.3390/ijms21082690DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215398PMC

Complement-Dependent Synaptic Uptake and Cognitive Decline after Stroke and Reperfusion Therapy.

J Neurosci 2020 May 14;40(20):4042-4058. Epub 2020 Apr 14.

Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina 29425

Despite the success of reperfusion therapy in significantly reducing the extent of infarct expansion after stroke, the effect of revascularization on poststroke neuroinflammation and the role of anti-inflammatory strategies in postreperfusion era are yet to be explored. Here, we investigate whether the neuroinflammatory response may still contribute to neurologic deficits after reperfused stroke by using targeted complement inhibition to suppress poststroke neuroinflammation in mice with or without concurrent reperfusion therapy. Complement inhibition was achieved using B4Crry, an injury site-targeted inhibitor of C3 activation. Read More

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http://dx.doi.org/10.1523/JNEUROSCI.2462-19.2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219298PMC

Thrombolytics for venous thromboembolic events: a systematic review with meta-analysis.

Blood Adv 2020 Apr;4(7):1539-1553

Department of Internal Medicine and Centro Evidencia Unversidad Católica, Pontificia Universidad Católica de Chile, Santiago, Chile; and.

Thrombolytic therapy might reduce venous thromboembolism-related mortality and morbidity, but it could also increase the risk of major bleeding. We systematically reviewed the literature to evaluate the effectiveness and safety of thrombolytics in patients with pulmonary embolism (PE) and/or deep venous thrombosis (DVT). We searched Medline, Embase, and Cochrane databases for relevant randomized controlled trials up to February 2019. Read More

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http://dx.doi.org/10.1182/bloodadvances.2020001513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160254PMC

[Medical Malpractice in Neurological Diseases].

Authors:
Masayuki Ohira

Brain Nerve 2020 Apr;72(4):287-294

Department of Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University.

The results of medical lawsuits in Japan can affect actual clinical settings, and it might be useful to analyze medical lawsuits in order to understand medical issues. Some diseases such as subarachnoid hemorrhage, cerebral infarction treated with thrombolytic therapy and treatable encephalitis could cause problems, which in turn may lead to lawsuits, when the results of treatment for those situations are fatal. In addition, there are cases in which other neurological diseases are related to litigation. Read More

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http://dx.doi.org/10.11477/mf.1416201526DOI Listing

Quantitative pharmacokinetic evaluation of Subtilisin QK-2 after a bolus IV injection in a rat model using a novel sandwich enzyme-linked immunosorbent assay.

J Pharm Biomed Anal 2020 Mar 17;186:113264. Epub 2020 Mar 17.

State Key Laboratory of Virology, Modern Research Center, College of Life Sciences, Wuhan University, Wuhan 430072, China. Electronic address:

Intravascular thrombosis is a main cause of multiple cardiovascular diseases. A high thrombolytic activity of the microbial fibrinolytic enzyme Subtilisin QK-2, which is highly homologous to Nattokinase, shows great exploitable potential in thrombolytic therapy. However, the lack of a sensitive detection method limits the further analysis of Subtilisin QK-2 in vivo. Read More

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http://dx.doi.org/10.1016/j.jpba.2020.113264DOI Listing

Medicinal leech therapy in venous congestion and various ulcer forms: Perspectives of Western, Persian and Indian medicine.

J Tradit Complement Med 2020 Mar 3;10(2):104-109. Epub 2019 Aug 3.

Clinic of Integrative Medicine, Kliniken Essen Mitte, Medical Faculty University Duisburg-Essen, Essen, Germany.

The use of medicinal leech therapy (MLT) is the subject of many articles describing basic pharmacological principles, application procedures, or efficacy and safety of the broad range of therapeutic indications. This review is focused on the information gap between Eastern and Western medicine when medicinal leech therapy is used in wound healing. Impaired wound healing has serious consequences for patients' health in a variety of clinical conditions. Read More

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http://dx.doi.org/10.1016/j.jtcme.2019.08.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109469PMC

Early diagnosis and precision treatment of right ovarian vein and inferior vena cava thrombosis following caesarean section: A case report.

Exp Ther Med 2020 Apr 25;19(4):2923-2926. Epub 2020 Feb 25.

Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, Jiangsu 210009, P.R. China.

Ovarian vein thrombosis (OVT) is a rare medical complication that is most often diagnosed in the post-partum period. OVT can lead to conditions, including sepsis, inferior vena cava (IVC), pulmonary emboli and mortality. The current study outlines a case of a patient who experienced pain in the lower abdomen and waist without fever postpartum following caesarean section (CS). Read More

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http://dx.doi.org/10.3892/etm.2020.8548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086212PMC
April 2020
0.941 Impact Factor

[Pharmacoinvasive Approach to the Treatment of Acute ST-Segment Elevation Myocardial Infarction. Current State of the Problem].

Kardiologiia 2020 Feb 4;60(1):62-69. Epub 2020 Feb 4.

Russian Medical Research Center of Cardiology.

The articled focused on the pharmacoinvasive approach to the treatment of acute ST-segment elevation myocardial infarction. Current guidelines prioritize the primary transcutaneous coronary intervention. However, in both the Russian Federation and other countries, there are some peculiarities (logistic issues, specific aspects of infrastructure of medical facilities), which may hamper timely conduction of the endovascular treatment. Read More

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http://dx.doi.org/10.18087/cardio.2020.1.n699DOI Listing
February 2020