30,756 results match your criteria Thrombolytic Therapy


Atypical Thrombotic Thrombocytopenic Purpura Presenting as Stroke.

Case Rep Hematol 2019 14;2019:7425320. Epub 2019 Jan 14.

Division of Hematology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6411 Fannin Street, Houston 77030, USA.

Here we report a case of atypical thrombotic thrombocytopenic purpura that presented as an ischemic cerebrovascular accident. A 56-year-old man with multiple cardiovascular risk factors presented with sudden left-sided weakness, slurred speech, and left facial droop. He showed mild improvement when he was treated with thrombolytic therapy according to the hospital stroke protocol. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1155/2019/7425320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350572PMC
January 2019
1 Read

Impending Paradoxical Embolism.

Ann Thorac Surg 2019 Feb 11. Epub 2019 Feb 11.

Department of Echocardiograph, Asia Heart Hospital, Wuhan, P.R. China. Electronic address:

Impending paradoxical embolism (IPDE) is the presence of a thrombus in the patent foramen ovale (PFO). Usually, IPDE is diagnosed by echocardiography or an Multislice computer tomography (MSCT) scan and is performed during the evaluation of a patient presenting with suspected pulmonary embolism (PE). We report two patients who presented with IPDE and were successfully treated with cardiac surgery and thrombolytic therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2019.01.011DOI Listing
February 2019

Coagulation factor XIII-A and activated XIII-A decrease in some deep vein thrombosis patients following catheter-directed thrombolysis.

Blood Coagul Fibrinolysis 2019 Feb 11. Epub 2019 Feb 11.

Michael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia.

: To assess the effect of tissue plasminogen activator administered during catheter-directed thrombolysis (CDT) on coagulation factor XIII (FXIII). Thrombolytic therapy carries significant risks, such as life-threatening bleeds. The mechanisms responsible for major bleeds and intracerebral hemorrhages during thrombolysis are not fully understood. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MBC.0000000000000797DOI Listing
February 2019
1 Read

Time Is Brain.

Stroke 2019 Feb 14:STROKEAHA118024214. Epub 2019 Feb 14.

From the Institute and Policlinic of Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus, Dresden,Germany.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/STROKEAHA.118.024214DOI Listing
February 2019

Thrombolysis in Acute Ischemic Stroke after Idarucizumab for Dabigatran Etexilate Reversal in Elderly: A Case Report.

J Vasc Interv Neurol 2018 Nov;10(2):15-17

Stroke Unit, Department of Neuroscience, AOU Sassari, Italy.

Introduction: Dabigatran is one of the nonvitamin K antagonist oral anticoagulants. Thrombolytic treatment with intravenous recombinant tissue plasminogen activator is contraindicated in patients taking a DOAC. Idarucizumab was recently approved for dabigatran-activity reversing in severe bleeding, emergency surgery, or urgent procedures, but many attempts have been made to use idarucizumab in patients presenting with acute ischemic stroke in order to be eligible for thrombolysis. Read More

View Article

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350876PMC
November 2018
7 Reads

Management of high risk pulmonary embolism - a single center experience.

Folia Med Cracov 2018 ;58(4):75-83

Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background And Aim: Patients with acute pulmonary embolism (APE) associated with hemodynamic instability, i.e. high-risk APE (HR-APE), are at risk for early mortality and require urgent reperfusion therapy with thrombolysis or embolectomy. Read More

View Article

Download full-text PDF

Source
January 2018
1 Read

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial.

Lancet 2019 Feb 6. Epub 2019 Feb 6.

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, UK.

Background: Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressure for optimal outcome is uncertain. We assessed intensive blood pressure lowering compared with guideline-recommended blood pressure lowering in patients treated with alteplase for acute ischaemic stroke.

Methods: We did an international, partial-factorial, open-label, blinded-endpoint trial of thrombolysis-eligible patients (age ≥18 years) with acute ischaemic stroke and systolic blood pressure 150 mm Hg or more, who were screened at 110 sites in 15 countries. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(19)30038-8DOI Listing
February 2019
1 Read

Evaluation of Activity Kinetic Parameters of SK319cys, As a New Cysteine Variant of Streptokinase: A Comparative Study.

Curr Pharm Biotechnol 2019 Feb 8. Epub 2019 Feb 8.

R&D department, Research and production complex, Pasteur Institute of Iran, Karaj. Iran.

Background: Despite the extensive use of streptokinase in thrombolytic therapy, its administration may have some shortcomings like allergic reactions and relatively low half life. Specific PEGylation on cysteine at desired sites of streptokinase may alleviate these deficiencies and improve the quality of treatment.

Objective: This study was carried out to create a new cystein variant of streptokinase and compare its activity with formerly mutated SK263cys, SK45cys and intact streptokinase (Ski) to introduce superior candidates for specific PEGylation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2174/1389201020666190208155808DOI Listing
February 2019
1 Read

The Young Myocardial Infarction Study of the Western Indians: YOUTH Registry.

Glob Heart 2019 Feb 4. Epub 2019 Feb 4.

Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Center, Asarwa, Ahmedabad, Gujarat, India.

Background: Myocardial infarction is among the leading causes of morbidity and mortality in young adults around the world.

Objectives: In the YOUTH (Young Myocardial Infarction Study of the Western Indians) registry, we aimed to evaluate risk factor profile and angiographic outcomes of reperfusion therapies of infarct-related artery in young western Indians (≤40 years) having ST-segment elevation myocardial infarction.

Methods: A total of 1,179 consecutive patients aged ≤40 years who presented with ischemic heart disease from June 2012 to December 2014 were enrolled in the YOUTH registry. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gheart.2018.12.001DOI Listing
February 2019
1 Read

Association of Elevated Blood Pressure Levels with Outcomes in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A Systematic Review and Meta-Analysis.

J Stroke 2019 Jan 31;21(1):78-90. Epub 2019 Jan 31.

Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Background And Purpose: Although arbitrary blood pressure (BP) thresholds exist for acute ischemic stroke (AIS) patients eligible for intravenous thrombolysis (IVT), current international recommendations lack clarity on the impact of mean pre- and post-IVT BP levels on clinical outcomes.

Methods: Eligible studies involving IVT-treated AIS patients were identified that reported the association of mean systolic BP (SBP) or diastolic BP levels before and after IVT with the following outcomes: 3-month favorable functional outcome (modified Rankin Scale [mRS] scores of 0-1) and 3-month functional independence (mRS scores of 0-2), 3-month mortality and symptomatic intracranial hemorrhage (sICH). Unadjusted analyses of standardized mean differences and adjusted analyses of studies reporting odds ratios (ORadj) per 10 mm Hg BP increment were performed using random-effects models. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.5853/jos.2018.02369DOI Listing
January 2019
1 Read

Visualizing the Distribution of Matrix Metalloproteinases in Ischemic Brain Using In Vivo F-Magnetic Resonance Spectroscopic Imaging.

Contrast Media Mol Imaging 2019 6;2019:8908943. Epub 2019 Jan 6.

Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan.

Matrix metalloproteinases (MMPs) damage the neurovascular unit, promote the blood-brain barrier (BBB) disruption following ischemic stroke, and play essential roles in hemorrhagic transformation (HT), which is one of the most severe side effects of thrombolytic therapy. However, no biomarkers have presently been identified that can be used to track changes in the distribution of MMPs in the brain. Here, we developed a new F-molecular ligand, TGF-019, for visualizing the distribution of MMPs in vivo using F-magnetic resonance spectroscopic imaging (F-MRSI). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1155/2019/8908943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339703PMC
January 2019
1 Read

Combined application of hypothermia and medical gases in cerebrovascular diseases.

Med Gas Res 2018 Oct-Dec;8(4):172-175. Epub 2019 Jan 9.

Department of Neurosurgery & Brain and Nerve Research Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.

Cerebrovascular diseases have a heavy burden on society and the family. At present, in the treatment of cerebrovascular diseases, the recognized effective treatment method is a thrombolytic therapy after cerebral infarction, but limited to the time window problem, many patients cannot benefit. Other treatments for cerebrovascular disease are still in the exploration stage. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4103/2045-9912.248269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352567PMC
January 2019
1 Read

Timing of Anticoagulation in Atrial Fibrillation Status Post Cardioembolic Stroke.

J Pharm Pract 2019 Jan 31:897190019825577. Epub 2019 Jan 31.

2 Pharmacy Practice Department, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA.

Background:: Anticoagulation is the mainstay of secondary stroke prevention in patients with atrial fibrillation; however, few studies have assessed the optimal timing for initiation of anticoagulation post cardioembolic stroke. In the 2 weeks following an acute cardioembolic stroke, the risk of recurrent stroke is as high as 8%, but this risk must be balanced against the risk of hemorrhagic transformation with early initiation of anticoagulation.

Purpose:: This study described the time to initiation of anticoagulation and evaluated the in-hospital incidence of hemorrhagic and ischemic complications in 106 patients with atrial fibrillation post an acute cardioembolic stroke. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0897190019825577DOI Listing
January 2019
5 Reads

Evaluation of Rescue Thrombolysis in Cardiac Arrest Secondary to Suspected or Confirmed Pulmonary Embolism.

Ann Pharmacother 2019 Jan 30:1060028019828423. Epub 2019 Jan 30.

2 Duke University Hospital, Durham, NC, USA.

Background: Pulmonary embolism (PE) is the associated cause of unexplained cardiac arrest in 5% to 13% of patients. Although thrombolytic agents have been studied, patient outcomes during cardiac arrest are lacking.

Objective: The purpose of this study was to describe outcomes of patients who received thrombolytic therapy during cardiac arrest for suspected or confirmed PE. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/1060028019828423DOI Listing
January 2019
1 Read

The safety and efficacy of tPA intravenous thrombolysis for treating acute ischemic stroke patients with a history of cerebral hemorrhage.

Braz J Med Biol Res 2019 Jan 24;52(2):e7739. Epub 2019 Jan 24.

Department of Neurology, The Second Hospital of Shandong University, Jinan, Shandong, China.

Alteplase (tPA) intravenous thrombolysis is an effective treatment for acute ischemic stroke (AIS) when administered within 4.5 h of initial stroke symptoms. Here, its safety and efficacy were evaluated among AIS patients with a previous history of cerebral hemorrhage. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1590/1414-431X20187739DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345357PMC
January 2019

Effects of thrombolysis within 6 hours on acute cerebral infarction in an improved rat embolic middle cerebral artery occlusion model for ischaemic stroke.

J Cell Mol Med 2019 Jan 29. Epub 2019 Jan 29.

Department of Neurology, Shandong Provincial Qianfoshan Hospital, Affiliated to Shandong University, Jinan, Shandong, China.

Recombinant tissue plasminogen activator (rt-PA) is the first-line drug for revascularization in acute cerebral infarction (ACI) treatment. In this study, an improved rat embolic middle cerebral artery occlusion model for ischaemic stroke was used and the rats were killed on the first, third and seventh day after model establishment. Increases in infarct volume were significantly less in the thrombolytic group than in the conventional group at every time-point. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1111/jcmm.14120
Publisher Site
http://dx.doi.org/10.1111/jcmm.14120DOI Listing
January 2019
4 Reads

Fast-tracking acute stroke care in China: Shenzhen Stroke Emergency Map.

Postgrad Med J 2019 Jan 29. Epub 2019 Jan 29.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

China has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Read More

View Article

Download full-text PDF

Source
http://pmj.bmj.com/lookup/doi/10.1136/postgradmedj-2018-1361
Publisher Site
http://dx.doi.org/10.1136/postgradmedj-2018-136192DOI Listing
January 2019
3 Reads

Acute alcohol intoxication may cause delay in stroke treatment - case reports.

BMC Neurol 2019 Jan 29;19(1):14. Epub 2019 Jan 29.

Department of Neurology, Faculty of Medicine, University of Debrecen, Moricz Zs. krt 22, Debrecen, 4032, Hungary.

Background: The signs and symptoms of acute alcohol intoxication resemble those of vertebrobasilar stroke. Due to their shared symptoms including double vision, nystagmus, dysarthria, and ataxia, the differential diagnosis of alcohol intoxication and vertebrobasilar stroke may pose a challenge. Moreover, if alcohol intoxication and stroke occur simultaneously, the signs and symptoms of stroke may be attributed to the effects of alcohol, leading to delayed stroke diagnosis and failure to perform reperfusion therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12883-019-1241-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350361PMC
January 2019
1 Read

A case of thrombolytic therapy with recombinant tissue plasminogen activator for mechanical valve thrombosis at 9 weeks of pregnancy in a Japanese woman.

J Cardiol Cases 2019 Jan 17;19(1):15-18. Epub 2018 Sep 17.

Division of Cardiology, Shinshu University Hospital, Nagano, Japan.

A 29-year-old woman was admitted to our hospital due to diagnosis of pregnancy at 5 weeks and a day. She underwent valve replacement with mechanical heart valve (MHV: SJM valve) for congenital mitral valve regurgitation, when 11 years old. Warfarin 4 mg was used for anticoagulation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jccase.2018.08.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342610PMC
January 2019
1 Read

Innovations in Acute Stroke Reperfusion Strategies.

Ann Indian Acad Neurol 2019 Jan-Mar;22(1):6-12

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Vascular neurology is witnessing unprecedented innovations in the management of acute ischemic stroke, especially in reperfusion strategies. The emergence of mechanical thrombectomy with new generation devices has revolutionized the treatment of acute ischemic stroke with large vessel occlusion. The reperfusion strategies are evolving with the extension of the window period for thrombolysis and endovascular therapy through the concept of "tissue clock" in addition to the established "time clock. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4103/aian.AIAN_263_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327700PMC
January 2019
3 Reads

Hemorrhagic conversion after alteplase administration in a patient with vasculitis and acute ischemic stroke.

Am J Health Syst Pharm 2019 Feb;76(4):211-213

Department of Pharmacy, Wesley Medical Center, Wichita, KS.

Purpose: A case of alteplase administration to a patient with vasculitis and acute ischemic stroke (AIS) is reported.

Summary: A 38-year-old woman with a recent diagnosis of granulomatosis with polyangiitis (GPA) received alteplase for AIS and developed symptomatic hemorrhagic conversion. Published reports regarding the safety of thrombolytic therapy in patients with a high inflammatory burden are inconsistent. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/ajhp/zxy048DOI Listing
February 2019
1 Read

Efficacy of Sonothrombolysis Using Microbubbles Produced by a Catheter-Based Microfluidic Device in a Rat Model of Ischemic Stroke.

Ann Biomed Eng 2019 Jan 28. Epub 2019 Jan 28.

Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.

Limitations of existing thrombolytic therapies for acute ischemic stroke have motivated the development of catheter-based approaches that utilize no or low doses of thrombolytic drugs combined with a mechanical action to either dissolve or extract the thrombus. Sonothrombolysis accelerates thrombus dissolution via the application of ultrasound combined with microbubble contrast agents and low doses of thrombolytics to mechanically disrupt the fibrin mesh. In this work, we studied the efficacy of catheter-directed sonothrombolysis in a rat model of ischemic stroke. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10439-019-02209-0DOI Listing
January 2019
2 Reads
3.195 Impact Factor

Role of intracoronary fibrinolytic therapy in contemporary PCI practice.

Cardiovasc Revasc Med 2018 Dec 27. Epub 2018 Dec 27.

Department of Internal Medicine, Rashid Hospital, Dubai, United Arab Emirates.

Plaque rupture or plaque erosion leads to intracoronary thrombus formation resulting in coronary artery occlusion and ST-segment elevation myocardial infarction. Early restoration of blood flow in occluded coronary artery is the mainstay of therapy and it can be achieved by either thrombolytic therapy or primary percutaneous coronary intervention (P-PCI) or a combination of these two in many different ways. It has been proved that primary PCI is better than thrombolytic therapy in establishing early and effective recanalization of infarct related artery, reducing major adverse cardiovascular events (MACE) and increasing survival. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carrev.2018.11.021DOI Listing
December 2018
1 Read

Secondary hemorrhagic complications in aneurysmal subarachnoid hemorrhage: when the impact hits hard.

J Neurosurg 2019 Jan 25:1-8. Epub 2019 Jan 25.

1Department of Neurosurgery, University Hospital, University of Duisburg-Essen; and.

OBJECTIVEClinical data on secondary hemorrhagic complications (SHCs) in patients with aneurysmal subarachnoid hemorrhage (SAH) are sparse and mostly limited to ventriculostomy-associated SHCs. This study aimed to elucidate the incidence, risk factors, and impact on outcome of SHCs in a large cohort of SAH patients.METHODSAll consecutive patients with ruptured aneurysms treated between January 2003 and June 2016 were eligible for this study. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3171/2018.9.JNS182105DOI Listing
January 2019
3 Reads

Dynamic Detection of Thrombolysis in Embolic Stroke Rats by Synchrotron Radiation Angiography.

Transl Stroke Res 2019 Jan 24. Epub 2019 Jan 24.

Department of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China.

A rodent model of embolic middle cerebral artery occlusion is used to mimic cerebral embolism in clinical patients. Thrombolytic therapy is the effective treatment for this ischemic injury. However, it is difficult to detect thrombolysis dynamically in living animals. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12975-019-0687-6DOI Listing
January 2019
1 Read

[Advances in the research of transcatheter arterial thrombolysis for severe frostbite therapy].

Zhonghua Shao Shang Za Zhi 2019 Jan;35(1):74-76

Department of Interventional Radiology, General Hospital of PLA, Beijing 100853, China.

Severe frostbite (grade Ⅲ to Ⅳ) is a common disease accompanied with high disability rate in cold regions, especially for military training and disaster events in cold regions. The treatment of severe frostbite mainly includes rapid rewarming in the early stage and amputation in the later stage; while the damage of vascular endothelial cells, microvascular thrombosis, and decreased tissue perfusion secondary to severe frostbite are important factors affecting prognosis. Transcatheter arterial thrombolysis is a new technique for the treatment of severe frostbite. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2019.01.015DOI Listing
January 2019

The impact of smoking on mortality after acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: a retrospective cohort outcome study at 3 years.

J Thromb Thrombolysis 2019 Jan 21. Epub 2019 Jan 21.

The South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK.

The "smoker's paradox", where smokers have improved survival post-myocardial infarction, was predominantly observed in the thrombolytic era. However, evidence for the smoker's paradox in the current era of PCI therapy is both limited and inconsistent. We aimed to examine the effect of smoking status on survival in unselected ST-elevation myocardial infarction (STEMI) patients managed by primary percutaneous coronary intervention (PCI). Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11239-019-01812-1
Publisher Site
http://dx.doi.org/10.1007/s11239-019-01812-1DOI Listing
January 2019
5 Reads

Rescue thrombolysis partial failure in massive PE complicated with in-transit thrombus.

Int Med Case Rep J 2019 9;12:9-14. Epub 2019 Jan 9.

Cardiovascular Research Center, Shahid Behesti University of Medical Science, Tehran, Iran.

A 58-year-old man who presented with syncope, dyspnea, and hemodynamic compromise was found to have large free-floating right atrial thrombuses on echocardiogram. Decision was made to transfer the patient for emergent atriotomy. Cardiothoracic surgeons declared the patient as inoperable and recommended to use a lytic agent. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2147/IMCRJ.S189944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330970PMC
January 2019
1 Read

Unusual fluoroscopic finding during atrial fibrillation cryoablation.

Heart 2019 Jan 19. Epub 2019 Jan 19.

Cardiology Department, Leeds General Infirmary, Leeds, UK.

Question: What is the next most appropriate course of action?Embolectomy.Usual postprocedural care.Thrombolytic therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/heartjnl-2018-314225DOI Listing
January 2019

Superior vena cava obstruction post laparoscopic cholecystectomy: A case report.

Clin Case Rep 2019 Jan 20;7(1):120-122. Epub 2018 Nov 20.

Faculty of Medicine, Department of Surgery and Anaesthetics National University of Science and Technology Bulawayo Zimbabwe.

Clinicians should have a high index of suspicion of superior vena cava obstruction in a patient presenting with painful lateral neck and ipsilateral chest swelling post laparoscopic procedures. High doses of Clexane can be used as a substitute for thrombolytic therapy where it is contraindicated. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1002/ccr3.1930
Publisher Site
http://dx.doi.org/10.1002/ccr3.1930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333062PMC
January 2019
3 Reads

Efficacy of Tirofiban Administered at Different Time Points after Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Ischemic Stroke.

J Stroke Cerebrovasc Dis 2019 Jan 14. Epub 2019 Jan 14.

Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, China. Electronic address:

Objective: To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke.

Methods: Patients who underwent intravenous thrombolysis with alteplase and fulfilled other inclusion criteria were randomly divided into 4 groups according to the time points of tirofiban administration: Group A (2 h), Group B (2-12 h), Group C (12-24 h), and Group D (control). The changes in National Institutes of Health Stroke Scale score, modified Rankin Scale score, and adverse events were analyzed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.044DOI Listing
January 2019
2 Reads

Thrombolysis Therapy in Specialized and Non-specialized Stroke Units.

Arch Med Res 2019 Jan 12. Epub 2019 Jan 12.

University of South Carolina, School of Medicine, Greenville, SC, USA. Electronic address:

Background: The benefits of a special stroke care unit (SSCU) over a non-specialized stroke care unit (NSSCU) is well documented in the literature. However, there are concerns that the benefits seen in the SSCU do not consider clinical risk factors that affect thrombolysis therapy.

Method: Retrospective data were collected from a stroke registry between January 1, 2010-June 30, 2016. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S01884409183074
Publisher Site
http://dx.doi.org/10.1016/j.arcmed.2019.01.002DOI Listing
January 2019
4 Reads

Futile reperfusion and predicted therapeutic benefits after successful endovascular treatment according to initial stroke severity.

BMC Neurol 2019 Jan 15;19(1):11. Epub 2019 Jan 15.

Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

Background: Futile reperfusion (poor functional status despite successful reperfusion) was observed in up to 67% of patients enrolled in recent endovascular treatment (EVT) clinical trials. We investigated the impact of baseline stroke severity on both futile reperfusion and therapeutic benefit of successful EVT.

Methods: Using a prospective multicenter stroke registry, we identified consecutive ischemic stroke patients with anterior circulation large artery occlusion, who were reperfused successfully by EVT (Thrombolysis in Cerebral Infarction grade 2b-3). Read More

View Article

Download full-text PDF

Source
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-
Publisher Site
http://dx.doi.org/10.1186/s12883-019-1237-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6332890PMC
January 2019
6 Reads

Thrombotic/Thrombolytic Balance as a Cardiac Treatment Determinant in Patients With Diabetes Mellitus and Coronary Artery Disease.

J Am Heart Assoc 2019 Jan;8(2):e011207

1 Department of Diabetes, Endocrinology, and Metabolism Center Hospital National Center for Global Health and Medicine Tokyo Japan.

Background This study aimed to assess whether the plasminogen activator inhibitor-1/tissue plasminogen activator ( PAI -1/ tPA ) ratio as a prothrombotic state is useful for optimizing cardiac treatment strategy. Methods and Results Using BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial data, we used a Cox proportional hazard model to calculate hazard ratios with 95% CI s for cardiac events in patients receiving early revascularization (percutaneous coronary intervention or coronary artery bypass grafting) or medical therapy, separately in patients with low (n=1276) and high (n=894) PAI -1/ tPA ratios. The primary outcome was major cardiac events, which was a composite end point including cardiac death and nonfatal myocardial infarction. Read More

View Article

Download full-text PDF

Source
https://www.ahajournals.org/doi/10.1161/JAHA.118.011207
Publisher Site
http://dx.doi.org/10.1161/JAHA.118.011207DOI Listing
January 2019
4 Reads

Percutaneous mechanical thrombectomy in the treatment of acute iliofemoral deep vein thrombosis: a systematic review.

Hong Kong Med J 2019 Feb 14;25(1):48-57. Epub 2019 Jan 14.

Department of Surgery, Queen Mary Hospital, Pokfulam, Hong Kong.

Background: Conventional treatment of deep vein thrombosis (DVT) of the lower extremities by anticoagulation alone has been proven to be insufficient to prevent recurrence and post-thrombotic syndrome (PTS). Early restoration of venous patency and preservation of valvular function by endovascular surgery has been advocated. The aim of this study was to review the efficacy and safety of percutaneous mechanical thrombectomy (PMT) against catheter-directed thrombolysis (CDT) in the treatment of acute iliofemoral DVT. Read More

View Article

Download full-text PDF

Source
https://www.hkmj.org/earlyrelease/hkmj187491.html
Publisher Site
http://dx.doi.org/10.12809/hkmj187491DOI Listing
February 2019
3 Reads

Nucleic Acid Therapies for Ischemic Stroke.

Neurotherapeutics 2019 Jan 11. Epub 2019 Jan 11.

Division of Neurocritical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.

Stroke remains a leading cause of disability and death worldwide despite significant scientific and therapeutic advances. Therefore, there is a critical need to improve stroke prevention and treatment. In this review, we describe several examples that leverage nucleic acid therapeutics to improve stroke care through prevention, acute treatment, and recovery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13311-019-00710-xDOI Listing
January 2019
2 Reads

Different treatments for acute myocardial infarction patients via outpatient clinics and emergency department.

Medicine (Baltimore) 2019 Jan;98(2):e13883

Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan.

To investigate relevant factors and patients with acute myocardial infarction (AMI) were admitted during between weekdays and weekends period.Retrospective population-based study setting: from the 2005 population-based national health insurance underwriting database of millions of people, random sampling (National Health Insurance Research Database [NHIRD]-Longitudinal Health Insurance Database [LHID] 2005).In 2000 to 2009 data of NHIRD, subjects presented with first episode AMI who had received the thrombolytic therapy (TPA), or percutaneous coronary artery intervention (PTCA) or coronary artery bypass graft (CABG) during between weekdays and weekends period. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000013883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336652PMC
January 2019
3 Reads

The rate of early neurological deterioration occurring after thrombolytic therapy: A meta-analysis.

Brain Behav 2019 Jan 10:e01210. Epub 2019 Jan 10.

The Department of Neurology, General Hospital of Shen-Yang Military Region, Shenyang, China.

Objectives: The rate of early neurological deterioration (END) occurring after thrombolytic therapy is controversial. To explore a more precise estimation of the rate, a meta-analysis was conducted in the present study.

Methods: The relevant studies were identified by searching PubMed, EMBASE, and Cochrane Collaboration Database up to June 2018. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1002/brb3.1210
Publisher Site
http://dx.doi.org/10.1002/brb3.1210DOI Listing
January 2019
5 Reads

Treatment of the acute severe pulmonary embolism using endovascular methods.

Pol J Radiol 2018 1;83:e248-e252. Epub 2018 Jun 1.

Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.

Purpose: To present a single-centre experience with endovascular treatment of patients with severe symptoms secondary to acute pulmonary embolism (PE).

Material And Methods: Twenty-five patients were treated due to contraindications or deficient effects of systemic thrombolytic therapy. The patients were treated with a combination of fragmentation and aspiration, only aspiration, or only fragmentation, and with catheter-directed thrombolytic therapy. Read More

View Article

Download full-text PDF

Source
https://www.termedia.pl/doi/10.5114/pjr.2018.76785
Publisher Site
http://dx.doi.org/10.5114/pjr.2018.76785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323593PMC
June 2018
5 Reads

Predictors of Chronic Thromboembolic Pulmonary Hypertension.

Kardiologiia 2018 Dec 25;58(12):60-65. Epub 2018 Dec 25.

Pirogov Russian National Research Medical University (RNRMU).

Purpose: to elucidate predictors of development of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE).

Material And Methods: We included in this study 210 patients hospitalized with diagnosis of submassive and massive PTE from 2013 to 2017. In 1 to 3 years after initial hospitalization these patients were invited for control examination. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.18087/cardio.2018.12.10206DOI Listing
December 2018
3 Reads

Intra-arterial administration of cell-based biological agents for ischemic stroke therapy.

Expert Opin Biol Ther 2019 Mar 21;19(3):249-259. Epub 2019 Jan 21.

a 2nd Department of Radiology, Division of Interventional Radiology, School of Medicine , National and Kapodistrian University of Athens, Attikon University Hospital , Athens , Greece.

Introduction: Ischemic stroke is becoming a primary cause of disability and death worldwide. To date, therapeutic options remain limited focusing on mechanical thrombolysis or administration of thrombolytic agents. However, these therapies do not promote neuroprotection and neuro-restoration of the ischemic area of the brain. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1080/14712598.2019.1566454DOI Listing
March 2019
2 Reads

Timeliness of Nursing Care Delivered by Stroke Certified Registered Nurses as Compared to Non-Stroke Certified Registered Nurses to Hyperacute Stroke Patients.

J Neurosci Nurs 2019 Feb;51(1):54-59

Questions or comments about this article may be directed to Janet M. Lakomy, PhD RN, at She is an Adjunct Faculty, Texas A&M University, Texarkana, TX. Grace N. Fant, MSN RN SCRN, CHRISTUS St. Michael Health System, Texarkana, TX.

In this retrospective, nonexperimental, comparative descriptive design using convenience sampling, the timeliness of care delivered by 11 Stroke Certified Registered Nurses (SCRNs) to 95 hyperacute stroke patients (last known well of 4.5 hours or less) on the acute stroke protocol set by Target: Stroke Phase II Campaign Manual was compared with that of 13 non-SCRNs in a small, rural, level III stroke facility in the southwestern region of the United States. There was statistical significance in the total timeliness of care delivered by SCRNs to hyperacute stroke patients as compared with the non-SCRNs (t = -4. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/JNN.0000000000000414DOI Listing
February 2019
4 Reads

Causes of delayed arrival with acute ischemic stroke beyond the window period of thrombolysis.

J Family Med Prim Care 2018 Nov-Dec;7(6):1248-1252

Department of Neurology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India.

Context: Early thrombolytic therapy in acute ischemic stroke has proven to reduce the associated morbidity. Many factors are in play, delaying the arrival of patients.

Aim: To ascertain the factors causing delay in patients with acute ischemic stroke presenting beyond the window period of thrombolysis in and around Chennai, Tamil Nadu, India. Read More

View Article

Download full-text PDF

Source
http://www.jfmpc.com/text.asp?2018/7/6/1248/246446
Publisher Site
http://dx.doi.org/10.4103/jfmpc.jfmpc_122_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293923PMC
January 2019
6 Reads

Effect of Pretreatment Blood Pressure on Outcomes in Thrombolysed Acute Ischemic Stroke Patients: A Systematic Review and Meta-analysis.

J Stroke Cerebrovasc Dis 2019 Jan 3. Epub 2019 Jan 3.

Yong Loo Lin School of Medicine, National University of Singapore; Division of Neurology, Department of Medicine, National University Health System. Electronic address:

Background: Blood pressure (BP) is an important determinant of functional outcome in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (IV-tPA). Current guidelines recommend a BP target of 185/110 mmHg before IV-tPA bolus and maintaining it at less than 180/105 mmHg for the first 24 hours. However, the effect of blood pressure on various outcome measures after systemic thrombolysis remains unclear. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.008DOI Listing
January 2019
3 Reads
1.993 Impact Factor

Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke.

Am J Emerg Med 2018 Dec 31. Epub 2018 Dec 31.

Department of Neurology, Harran University School of Medicine Hospital, Sanliurfa, Turkey.

The simultaneous occurrence of acute ST-segment elevation myocardial infarction and acute ischemic stroke is an uncommon and complex clinical presentation. Although the medical treatment of both diseases is similar, data regarding optimal reperfusion therapy are limited. Nevertheless, use of tissue plasminogen activator may be a reasonable strategy for treatment of both diseases. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajem.2018.12.060DOI Listing
December 2018
3 Reads

Talk About Thrombolysis. Regular Case-Based Discussions of Stroke Thrombolysis Improve Door-to-Needle Time by 20%.

J Stroke Cerebrovasc Dis 2018 Dec 28. Epub 2018 Dec 28.

Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Biomagnetic Center, University Hospital, Germany. Electronic address:

Background: The outcome of stroke patients can be improved by a rapid initiation of thrombolytic therapy. Here, we sought to determine whether an additional simple but thorough case-based discussion of recent thrombolysed cases with the entire neurologic staff can improve the door-to-needle time without changes to the implemented stroke protocol.

Methods: For every performed thrombolysis, a route card, consisting of a timeline with 3 time points and target times, had to be completed by the attending neurologist. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10523057183070
Publisher Site
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.002DOI Listing
December 2018
2 Reads

tPA Point Mutation at Autolysis Loop Enhances Resistance to PAI-1 Inhibition and Catalytic Activity.

Thromb Haemost 2019 Jan 31;119(1):77-86. Epub 2018 Dec 31.

College of Chemistry, Fuzhou University, Fuzhou, Fujian, People's Republic of China.

Recombinant tissue-type plasminogen activator (r-tPA) was approved by U.S. Food and Drug Administration as a thrombolytic drug. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0038-1676518DOI Listing
January 2019
2 Reads

Determinants of in-hospital clinical outcome in patients with sub-massive pulmonary embolism.

Indian Heart J 2018 Dec 22;70 Suppl 3:S90-S95. Epub 2018 Jun 22.

Department of Cardiology Dayanand Medical College & Hospital Unit Hero, DMC Heart Institute, Ludhiana 141001, Punjab, India.

Introduction: There is limited data regarding in hospital determinants of clinical deterioration and outcome in sub massive pulmonary embolism (PE). We aimed to evaluate these determinants by comparing biomarkers, CT pulmonary angiogram echocardiography, electrocardiography variables.

Methods: 57 patients of sub massive PE diagnosed on CT pulmonary angiogram were included. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ihj.2018.06.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310705PMC
December 2018

GRACE and TIMI risk scores in predicting the angiographic severity of non-ST elevation acute coronary syndrome.

Indian Heart J 2018 Dec 12;70 Suppl 3:S250-S253. Epub 2018 Nov 12.

Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh.

Aims: We aimed to compare the GRACE and TIMI risk scores in patients with non- ST elevation acute coronary syndrome for their accuracy in predicting the angiographic severity of coronary artery disease.

Method: The cross-sectional study done in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from April, 2015-April, 2016. The patients admitted with non-ST elevation acute coronary syndrome were evaluated to calculate the GRACE and TIMI risk score. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ihj.2018.01.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309119PMC
December 2018