5,893 results match your criteria intravenous alteplase


Impact of intravenous alteplase on sub-angiographic emboli in high-resolution diffusion-weighted imaging following successful thrombectomy.

Eur Radiol 2021 May 8. Epub 2021 May 8.

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

Objective: Thrombus microfragmentation causing peripheral emboli (PE) during mechanical thrombectomy (MT) may modulate treatment effects, even in cases with successful reperfusion. This study aims to investigate whether intravenous alteplase is of potential benefit in reducing PE after successful MT.

Methods: Patients from a prospective study treated at a tertiary care stroke center between 08/2017 and 12/2019 were analyzed. Read More

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Safety of intravenous thrombolysis in stroke of unknown time of onset: A systematic review and meta-analysis.

J Thromb Thrombolysis 2021 May 7. Epub 2021 May 7.

Cerebrovascular Disease Center, Department of Neurology, People's Hospital, China Medical University. Address, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China.

The safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke of unknown time of onset (SUTO) was unclear and mostly concerned. We sought to investigate the safety in terms of symptomatic intracranial hemorrhage (sICH) and death in SUTO patients treated with IV-tPA. We searched PubMed and EMBASE from inception to 2 December 2020 for eligible studies reporting IV-tPA in SUTO patients compared to conservative medical therapy, or to stroke of known onset time (SKOT) treated with IV-tPA within standard time window. Read More

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Red cell index: A novel biomarker for 3-month mortality in acute ischemic stroke patients treated with intravenous thrombolysis.

Brain Behav 2021 May 4:e02170. Epub 2021 May 4.

Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Background: The red cell index (RCI) was described as a biomarker for evaluating respiratory function in previous studies, but the relationship between RCI and stroke, remained a mystery. The present study aimed to probe the association between RCI at 24-hr and 3-month mortality and functional outcomes among acute ischemic stroke (AIS) patients treated with recombinant tissue plasminogen activator (r-tPA).

Methods: A total of 217 AIS patients between January 2016 and January 2019 were recruited in this retrospective study. Read More

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Safety and efficacy of intravenous thrombolytic treatment in wake-up stroke: Experiences from a single center.

Authors:
Adam Wiśniewski

Brain Behav 2021 May 3:e02152. Epub 2021 May 3.

Department of Neurology, Faculty of Medicine, Collegium Medium in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.

Objectives: Wake-up stroke is an important clinical problem that may account for a quarter of all ischemic strokes. This study aimed to establish the safety and efficacy of intravenous thrombolytic treatment of wake-up strokes by comparing it to the standard thrombolysis treatment in strokes with clear onsets and wake-up strokes that did not receive reperfusion therapy.

Methods: This retrospective study enrolled 95 patients with ischemic strokes who underwent thrombolytic treatment with alteplase, including nine patients with wake-up strokes. Read More

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Mechanical Thrombectomy in Stroke. Experience from Switching from Stent Retriever Only to Stent Retriever Combined with Aspiration Catheter.

J Clin Med 2021 Apr 21;10(9). Epub 2021 Apr 21.

Department of Neurosurgery and Neurology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland.

Endovascular treatment is a rapidly evolving technique; therefore, there is a constant need to evaluate this method and its modifications. This paper discusses a single-center experience and the results of switching from the stent retriever only (SO) mechanical thrombectomy (MT) to the combined approach (CA), with a stent retriever and aspiration catheters.

Methods: The study involved a retrospective analysis of 70 patients undergoing MT with the use of either SO or CA. Read More

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Intravenous thrombolysis for acute ischemic stroke in centenarians.

Eur Geriatr Med 2021 Apr 28. Epub 2021 Apr 28.

Department of Neurology, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Km 9, 100, 28034, Madrid, Spain.

Purpose: The benefit of intravenous alteplase is well established for patients with disabling stroke symptoms regardless of age, although data on outcomes in centenarian patients are scarce. We present our experience in patients beyond 100 years.

Methods: Descriptive study including centenarians from our single-centre prospective registry who underwent intravenous thrombolysis with alteplase for acute ischemic stroke in our tertiary university hospital. Read More

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[Intravenous thrombolytic therapy with Revelisa of ischemic stroke in real-world clinical practice: interim results of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3. Vyp. 2):33-37

Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency, Moscow, Russia.

Objective: To assess the safety and efficacy of Revelisa in patients with ischemic stroke in real-world clinical practice.

Material And Methods: The interim analysis of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R included 223 patients (50.2% women and 49. Read More

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Related factors with orolingual angioedema after intravenous alteplase in acute ischemic stroke: results from a single-center cohort and meta-analysis.

Neurol Sci 2021 Apr 27. Epub 2021 Apr 27.

Stroke Centre - Department of Vascular Neurology, Hospital General Universitario Gregorio Marañón, Calle del Doctor Esquerdo, 46, 2800, Madrid, Spain.

Introduction: Orolingual angioedema (OA) after intravenous thrombolysis (IVT) with alteplase in acute stroke can be a life-threatening complication. Our aim was to describe its incidence, clinical features, and related factors.

Patients And Methods: We analyzed a single-center cohort of stroke patients treated with IVT in an 8-year period. Read More

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[Screening of intravenous thrombolysis for eligible patients with ischemic stroke].

Authors:
H Q Qin Y J Wang

Zhonghua Nei Ke Za Zhi 2021 May;60(5):476-482

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.

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Effectiveness of intravenous r-tPA versus UK for acute ischaemic stroke: a nationwide prospective Chinese registry study.

Stroke Vasc Neurol 2021 Apr 26. Epub 2021 Apr 26.

Neurology, General Hospital of Northern Theatre Command, Shenyang, Liaoning, China

Background: Intravenous recombinant tissue plasminogen activator (r-tPA) and urokinase (UK) are both recommended for the treatment of acute ischaemic stroke (AIS) in China, but with few comparative outcome data being available. We aimed to compare the outcomes of these two thrombolytic agents for the treatment of patients within 4.5 hours of onset of AIS in routine clinical practice in China. Read More

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Preexisting Mild Cognitive Impairment, Dementia, and Receipt of Treatments for Acute Ischemic Stroke.

Stroke 2021 Apr 27:STROKEAHA120032258. Epub 2021 Apr 27.

Department of Neurology and Stroke Program, University of Michigan, Ann Arbor. (D.A.L., L.B.M., D.B.Z., L.D.L.).

Background And Purpose: Differences in acute ischemic stroke (AIS) treatment by cognitive status are unclear, but some studies have found patients with preexisting dementia get less treatment. We compared AIS care by preexisting cognitive status.

Methods: Cross-sectional analysis of prospectively obtained data on 836 adults ≥45 with AIS from the population-based Brain Attack Surveillance in Corpus Christi project from 2008 to 2013. Read More

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A real-world single-centre analysis of alemtuzumab and cladribine for multiple sclerosis.

Mult Scler Relat Disord 2021 Apr 11;52:102945. Epub 2021 Apr 11.

University of Ottawa and The Ottawa Hospital Research Institute, Department of Medicine, The Ottawa Hospital General Campus, Multiple Sclerosis Clinic, 501 Smyth Road, Box 601, Ottawa ON K1H 8L6, Canada. Electronic address:

Background: Highly active MS may warrant higher efficacy treatments for disease control. However, these often confer more risk and have not been compared in head-to-head clinical trials, making relative efficacy and safety difficult to interpret. Alemtuzumab and cladribine are two high-efficacy treatments given as discrete courses separated by one year, followed by a durable response that potentially does not require ongoing treatment. Read More

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Low-Dose vs. Standard-Dose Intravenous Alteplase in Bridging Therapy Among Patients With Acute Ischemic Stroke: Experience From a Stroke Center in Vietnam.

Front Neurol 2021 9;12:653820. Epub 2021 Apr 9.

Stroke Center, Bach Mai Hospital, Ha Noi, Vietnam.

To date, the role of bridging intravenous thrombolysis before mechanical thrombectomy (MTE) is controversial but still recommended in eligible patients. Different doses of intravenous alteplase have been used for treating patients with acute ischemic stroke from large-vessel occlusion (LVO-AIS) in Asia, largely due to variations in the risks for intracerebral hemorrhage (ICH) and treatment affordability. Uncertainty exists over the potential benefits of treating low-dose alteplase, as opposed to standard-dose alteplase, prior to MTE among patients with LVO-AIS. Read More

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Factors that Influence Door-to-Needle Administration for Acute Stroke Patients in the Emergency Department.

J Neurosci Nurs 2021 Jun;53(3):134-139

Abstract: BACKGROUND: There is growing importance on discovering factors that delay time to intervention for acute ischemic stroke (AIS) patients, as rapid intervention is essential for better patient outcomes. The management of these patients involves a multidisciplinary effort and quality improvement initiatives to safely increase treatment with intravenous (IV) thrombolytic. The objective of this pilot study is to evaluate factors of acute stroke care in the emergency department (ED) and their impact on IV alteplase administration. Read More

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The Relationship of the Type of Intracerebral Hemorrhage to Early Disease Evolution and Long-Term Prognosis After r-tPA Thrombolysis.

Clin Appl Thromb Hemost 2021 Jan-Dec;27:1076029621992125

Department of Neurology, 26453The Second Affiliate Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

To investigate the relationship of different subtypes of intracerebral hemorrhage (ICH) to early disease evolution and long-term prognosis in patients with acute cerebral infarction after intravenous recombinant tissue plasminogen activator(r-tPA). Seventy ischemic stroke patients treated with intravenous r-tPA who underwent computed tomography (CT) within 24 hours after thrombolysis were divided into 4 types (hemorrhagic infarction type 1 [HI-1], HI-2, parenchymal hemorrhage type 1 [PH-1], or PH-2 which according to the size of the hematoma and the presence or absence of space-occupying effect). Early evolution of the disease was observed by the change in the National Institutes of Health Stroke Scale (NIHSS) score within 24 hours after thrombolysis. Read More

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Simultaneous cardiocerebral infarctions: a five-year retrospective case series reviewing natural history.

Singapore Med J 2021 04 19. Epub 2021 Apr 19.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Introduction: Concurrent cardiocerebral infarction (CCI), a rare condition defined as simultaneous occlusions in the cerebrovascular and coronary vessels, has high mortality but very limited literature on optimum treatment methods. A better understanding of the natural history and effect of treatment would improve patient outcomes.

Methods: Using our prospective stroke database from 2014 to 2018, ten consecutive patients with CCI were identified (incidence = 0. Read More

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Patient Characteristics and Outcomes Associated with Decline in Stroke Volumes During the Early COVID-19 Pandemic.

J Stroke Cerebrovasc Dis 2021 Jun 26;30(6):105569. Epub 2020 Dec 26.

Department of Neurointerventional Surgery, Ascension Columbia St. Mary's Hospital, Milwaukee, WI. Electronic address:

Background And Purpose: Delayed evaluation of stroke may contribute to COVID-19 pandemic-related morbidity and mortality. This study evaluated patient characteristics, process measures and outcomes associated with the decline in stroke presentation during the early pandemic.

Methods: Volumes of stroke presentations, intravenous thrombolytic administrations, and mechanical thrombectomies from 52 hospitals from January 1-June 30, 2020 were analyzed with piecewise linear regression and linear spline models. Read More

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Middle Cerebral Artery Thrombectomy: Clinical Findings and Technical Pearls: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Apr 16. Epub 2021 Apr 16.

Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

Mechanical thrombectomy as a treatment for large vessel occlusion to achieve rapid revascularization is supported in the literature.1-3 The presenting symptoms will localize to functions of the ischemic area. The middle cerebral artery (MCA) supplies areas of the frontal, temporal, and parietal cortices, as well as the basal ganglia. Read More

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Pinocembrin attenuates hemorrhagic transformation after delayed t-PA treatment in thromboembolic stroke rats by regulating endogenous metabolites.

Acta Pharmacol Sin 2021 Apr 15. Epub 2021 Apr 15.

Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Centre for Pharmaceutical Screening, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.

Hemorrhagic transformation (HT) is a common serious complication of stroke after thrombolysis treatment, which limits the clinical use of tissue plasminogen activator (t-PA). Since early diagnosis and treatment for HT is important to improve the prognosis of stroke patients, it is urgent to discover the potential biomarkers and therapeutic drugs. Recent evidence shows that pinocembrin, a natural flavonoid compound, exerts anti-cerebral ischemia effect and expands the time window of t-PA. Read More

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Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management.

Semin Neurol 2021 Apr 13. Epub 2021 Apr 13.

Department of Neurology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island.

Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) may co-occur simultaneously or in close temporal succession, with occurrence of one ischemic vascular event increasing a patient's risk for the other. Both employ time-sensitive treatments, and both benefit from expert consultation. Patients are at increased risk of stroke for up to 3 months following AMI, and aggressive treatment of AMI, including use of reperfusion therapy, decreases the risk of AIS. Read More

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Intravenous Thrombolysis for Acute Ischemic Stroke Due to Cardiac Myxoma.

Basic Clin Neurosci 2020 Nov-Dec;11(6):855-859. Epub 2020 Nov 1.

Department of Neurology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Myxoma may cause systemic embolization and frequently presents as ischemic stroke.

Case Presentation: There have been debates about whether it is safe to use recombinant tissue plasminogen activator (rt-PA) in patients with cardiac myxoma who referred with ischemic stroke to the hospital's emergency.

Results: The patient was a young case of atrial myxoma with initial presentation of acute cerebral infarction symptoms who was treated with intravenous rt-PA with no complications. Read More

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November 2020

Intravenous abciximab as a rescue therapy for immediate reocclusion after successful mechanical thrombectomy in acute ischemic stroke patients.

Platelets 2021 Apr 11:1-6. Epub 2021 Apr 11.

Rothschild Foundation Hospital, Interventional Neuroradiology Department, Paris, France.

- Immediate reocclusion after mechanical thrombectomy (MT) for acute ischemic stroke (AIS) is a rare but devastating condition associated with poor functional outcome. - The aim of this study was to gain insights into the mechanisms underlying immediate reocclusion, and to evaluate the efficacy and safety of the glycoprotein IIb/IIIa antagonist abciximab, for its treatment. - Clinical data were collected from April 2015 to April 2019 in a monocentric prospective registry of AIS patients treated by MT. Read More

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Endovascular Treatment of Infective Endocarditis-Related Acute Large Vessel Occlusion Stroke.

J Stroke Cerebrovasc Dis 2021 Jun 8;30(6):105775. Epub 2021 Apr 8.

Department of Neurology, Boston University Medical Center, 72 East Concord Street, Boston, MA 02118, United States; Department of Neurosurgery, Boston University Medical Center, United States. Electronic address:

Objectives: Embolic stroke is a frequent complication of infective endocarditis yet lacks acute treatment as intravenous thrombolysis should be avoided due to high risk of intracerebral hemorrhage. Mechanical thrombectomy for large vessel occlusion may be a promising treatment but there is limited data on safety outcomes in infective endocarditis.

Materials And Methods: In this multi-center retrospective case series, we reviewed data from patients with infective endocarditis-related large vessel occlusion who underwent mechanical thrombectomy in 9 US hospitals. Read More

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Thrombolytic strategies for ischemic stroke in the thrombectomy era.

J Thromb Haemost 2021 Apr 9. Epub 2021 Apr 9.

Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.

Twenty-five years ago, intravenous thrombolysis has revolutionized the care of patients with acute ischemic stroke. Since 2015, randomized clinical trials have demonstrated that mechanical thrombectomy improves functional outcome in stroke patients over intravenous thrombolysis alone. More recently, three randomized clinical trials have suggested that mechanical thrombectomy alone is non-inferior to a combined strategy with both intravenous thrombolysis and mechanical thrombectomy. Read More

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Decade-Long Nationwide Trends and Disparities in Use of Comfort Care Interventions for Patients With Ischemic Stroke.

J Am Heart Assoc 2021 Apr 7;10(8):e019785. Epub 2021 Apr 7.

Center for Outcomes Research Houston Methodist Houston TX.

Background Stroke remains one of the leading causes of disability and death in the United States. We characterized 10-year nationwide trends in use of comfort care interventions (CCIs) among patients with ischemic stroke, particularly pertaining to acute thrombolytic therapy with intravenous tissue-type plasminogen activator and endovascular thrombectomy, and describe in-hospital outcomes and costs. Methods and Results We analyzed the National Inpatient Sample from 2006 to 2015 and identified adult patients with ischemic stroke with or without thrombolytic therapy and CCIs using validated ( codes. Read More

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In imaging-selected ischemic stroke with unknown onset, alteplase increases favorable outcomes and death at 90 d.

Authors:
Michael D Hill

Ann Intern Med 2021 04 6;174(4):JC42. Epub 2021 Apr 6.

University of Calgary and Hotchkiss Brain Institute & Foothills Medical Centre, Calgary, Alberta, Canada (M.D.H.).

Source Citation: Thomalla G, Boutitie F, Ma H, et al. Lancet. 2020;396:1574-84. Read More

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European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke.

Eur Stroke J 2021 Mar 19;6(1):I-LXII. Epub 2021 Feb 19.

Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Hopital Sainte-Anne, Université de Paris, Paris, France.

Intravenous thrombolysis is the only approved systemic reperfusion treatment for patients with acute ischaemic stroke. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist physicians in their clinical decisions with regard to intravenous thrombolysis for acute ischaemic stroke. These guidelines were developed based on the ESO standard operating procedure and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Read More

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Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia.

Neurosciences (Riyadh) 2021 Apr;26(2):199-206

From the Division of Neurology (Khatri, AlSkaini, AlDayel, AlShammari, AlKhalaf, AlRasheed, AlKhathaami, AlOtaibi), Department of Medicine, Department of Nursing (Tarawneh, AlHizan), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, from the College of Medicine (Khatri, Masuadi, AlKhathaami, AlOtaibi), King Saud bin Abdulaziz University for Health Sciences, from King Abdullah International Medical Research Center (Khatri, Masuadi, AlKhathaami, AlOtaibi), from the College of Public Health (AlBoqami), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.

Objectives: To present the experience on stroke thrombolysis of a tertiary care center in Riyadh, KSA.

Methods: Cross-sectional, observational study of patients thrombolyzed between January 2012 and December 2018.

Results: Thrombolysis was performed in 148 patients (mean age: 58. Read More

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Low versus standard dose intravenous alteplase in the treatment of acute ischemic stroke in Egyptian patients.

Neurosciences (Riyadh) 2021 Apr;26(2):179-185

From the Neuro-Psychiatry Department (Salem, El-Sheik, Afifi), Menoufia University, Menoufia; from the Mataria Teaching Hospital (El-shanawany), Mataria, Egypt.

Objectives: To assess low dose altepase outcome and safety in comparison with a standard-dose regimen for acute ischemic stroke treatment in Egyptian patients.

Materials: An observational prospective cohort non-randomized single blinded study was carried out during the period from November 2017 to December 2018. Eighty Egyptian acute ischemic stroke patients, all eligible for intravenous alteplase, were subdivided into 2 groups (40 patients in each group). Read More

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Endovascular treatment for calcified cerebral emboli in patients with acute ischemic stroke.

J Neurosurg 2021 Apr 2:1-11. Epub 2021 Apr 2.

Departments of1Radiology and Nuclear Medicine.

Objective: Calcified cerebral emboli (CCE) are a rare cause of acute ischemic stroke. The authors aimed to assess the association of CCE with functional outcome, successful reperfusion, and mortality. Furthermore, they aimed to assess the effectiveness of intravenous alteplase treatment and endovascular treatment (EVT), as well as the best first-line EVT approach in patients with CCE. Read More

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