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Condition: Bleeding
Therapy: Thrombolytic Therapy

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Total 159 results found since Jan 2013.

Danhong injection combined with tPA protects the BBB through Notch-VEGF signaling pathway on long-term outcomes of thrombolytic therapy
In this study, the rats were randomly divided into sham group, vehicle group, DHI group (4 mL/kg), tPA group (5 mg/kg) and DHI+tPA group (4 mL/kg+ 2.5 mg/kg), administered intravenously 4.5 h since focal embolic stroke modeling. After 3 days and 7 days of cerebral ischemia, the neurological function of each treatment group was significantly improved compared with the vehicle group. The combination of DHI and tPA significantly reduced Evans blue (EB) penetration as well as the expressions of the proteins MMP-9, PAI-1 and P-selectin, while upregulating the expressions of claudin-5, occludin, and ZO-1 mRNA. Furthermore, the e...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - June 19, 2022 Category: Drugs & Pharmacology Authors: Simiao Chen Jinghui Zhang Min Li Jing Zhou Yuyan Zhang Source Type: research

Trapped cerebral thrombectomy device: A case report of a rare complication.
Abstract Intravenous thrombolysis with recombinant tissue plasminogen activator is currently the standard therapy for acute ischaemic stroke when started within 4.5 h of symptom onset. Systemic thrombolytic therapy can, however, lead to potentially lethal bleeding complications and is contra-indicated in several circumstances. Intra-arterial thrombolysis and/or intra-arterial thrombectomy can overcome these drawbacks and even increase the rate of recanalization. While intravenous thrombolysis is a relatively non-complex treatment, intra-arterial therapy in acute ischaemic stroke patients requires a dedicated int...
Source: Vascular - May 12, 2014 Category: Surgery Authors: Geuzebroek GS, Wille J, Vries JP, Schonewille W, Vos JA Tags: Vascular Source Type: research

The effect of recombinant tissue plasminogen activator on MMP-2 and MMP-9 activities in vitro.
In conclusion, this study showed that rtPA can increase the biological activity of MMP-2 and MMP-9 on posttranslational level. PMID: 24963695 [PubMed - in process]
Source: Neurological Research - December 2, 2014 Category: Neurology Tags: Neurol Res Source Type: research

Evaluation of Cerebral Perfusion in Patients Undergoing Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis.
Authors: Hirano T Abstract Currently, the indication for thrombolytic therapy using intravenous recombinant tissue plasminogen activator (rt-PA) is restricted strictly to patients with acute ischemic stroke within 4.5 h of onset. The effect of rt-PA declines over time; therefore, we need to minimize the time delay while generating imaging information. The use of cerebral blood flow imaging is not recommended within this time window. Conversely, the balance of efficacy and the risk of bleeding complications differ among patients > 4.5 h after onset. Several ongoing studies are using mismatch concepts to extend th...
Source: Neurologia Medico-Chirurgica - September 16, 2015 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Safe Intravenous Thrombolysis after Traumatic Cardiopulmonary Resuscitation with Rib Fractures: A Case Report
We report a case of successful intravenous thrombolysis for a distal middle cerebral artery occlusion shortly after traumatic cardiopulmonary resuscitation due to an episode of ventricular tachycardia. A high prevalence of fatal cardiac arrhythmias in acute stroke patients raises the question of safety when administrating thrombolytic therapy after traumatic cardiopulmonary resuscitation; guidelines do not provide a satisfactory statement about this. Our case suggests that intravenous tissue-type plasminogen activator for acute ischemic stroke can be administered after a thorough risk-to-benefit evaluation without major ad...
Source: Case Reports in Neurology - June 14, 2017 Category: Neurology Source Type: research

A case of cerebral infarction during a hemodialysis procedure successfully treated with recombinant tissue plasminogen activator
We report a case of a 75-year-old HD patient who presented with sudden aphasia during HD treatment. She was brought to the hospital for treatment for infarction. Following thrombolytic therapy, we achieved re-opening without complications. To our knowledge, no report has been published describing the patients who had a stroke during a maintenance HD session and were treated with r-tPA successfully. Although the number of HD patients treated with r-tPA is small and requires further investigation, thrombolytic therapy can be an alternative option. After weighing the risks and benefits and assessing each patient carefully, th...
Source: CEN Case Reports - June 12, 2018 Category: Urology & Nephrology Source Type: research

Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report
We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed. Fibrinolytic coagulopathy was successfully managed by monitoring fibrinogen levels and with the administration of cryoprecipitate and tranexamic acid.
Source: A&A Case Reports - December 1, 2018 Category: Anesthesiology Tags: Case Reports Source Type: research

The outcome of intra-aortic balloon pump support in acute myocardial infarction complicated by cardiogenic shock according to the type of revascularization: A comprehensive meta-analysis
Aims: Despite the recommendations of the current guidelines, scientific evidence continue to challenge the effectiveness of intra-aortic balloon pump (IABP) in acute myocardial infarction (AMI) complicated by cardiogenic shock. Moreover, 2 recent meta-analyses showed contrasting results. The aim of this study is to test the effect of IABP according to the type of therapeutic treatment of AMI: percutaneous coronary intervention (PCI), thrombolytic therapy (TT), or medical therapy without reperfusion. Articles published from January 1, 1986, to December 31, 2012, were collected and analyzed by meta-analysis.Methods and resul...
Source: American Heart Journal - March 27, 2013 Category: Cardiology Authors: Francesco Romeo, Maria Cristina Acconcia, Domenico Sergi, Alessia Romeo, Saverio Muscoli, Serafina Valente, Gian Franco Gensini, Flavia Chiarotti, Quintilio Caretta Tags: Curriculum in Cardiology Source Type: research

Intracranial hemorrhage due to pulmonary thromboembolism in heparin therapy and therapeutic management of patients hospitalized with massive pulmonary embolism after discharge.
Abstract A patient with a history of intracranial hemorrhage who was hospitalized due to massive pulmonary thromboembolism (PTE) was presented. A 59-year-old female patient had an intracranial hemorrhage while under anticoagulant therapy due to PTE after a knee operation. Therefore, the anticoagulant therapy was discontinued. Forty-seven days after the cessation of the anticoagulant treatment, the patient was admitted to the emergency department with a complaint of acute dyspnea and presyncope. Transthoracic echocardiography showed signs of right ventricular overload. Contrast-enhanced thorax computed tomography s...
Source: Turk Kardiyoloji Dernegi arsivi - May 1, 2013 Category: Cardiology Authors: Beşli F, Keçebaş M, Alişir MF, Güngören F Tags: Turk Kardiyol Dern Ars Source Type: research

Reperfusion of cerebral artery thrombosis by the GPIb-VWF blockade with the Nanobody ALX-0081 reduces brain infarct size in guinea pigs
Thrombolytic therapy is the cornerstone of treatment of acute atherothrombotic ischemic stroke but is associated with brain hemorrhage; antiplatelet therapy has limited efficacy and is still associated with intracranial bleeding. Therefore, new antithrombotic approaches with a better efficacy/safety ratio are required. We have assessed the effect of ALX-0081, a Nanobody against the A1 domain of von Willebrand factor (VWF) that blocks VWF binding to GPIb, of the thrombolytic agent recombinant tissue plasminogen activator (rtPA), and of the GPIIb/IIIa antagonist tirofiban, in a middle cerebral artery (MCA) thrombosis model i...
Source: Blood - June 20, 2013 Category: Hematology Authors: Momi, S., Tantucci, M., Van Roy, M., Ulrichts, H., Ricci, G., Gresele, P. Tags: Platelets and Thrombopoiesis, Thrombosis and Hemostasis Source Type: research

A multicenter, randomized, double‐blinded, placebo‐controlled phase III study of Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR III)
BackgroundIn adults, intraventricular thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) facilitates resolution of intraventricular haemorrhage (IVH), reduces intracranial pressure, decreases duration of cerebrospinal fluid diversion, and may ameliorate direct neural injury. We hypothesize that patients with small parenchymal haematoma volumes (<30 cc) and relatively large IVH causing acute obstructive hydrocephalus would have improved clinical outcomes when given injections of low‐dose rtPA to accelerate lysis and evacuation of IVH compared with placebo. MethodsThe Clot Lysis Evaluation of Ac...
Source: International Journal of Stroke - August 1, 2013 Category: Neurology Authors: Wendy C. Ziai, Stanley Tuhrim, Karen Lane, Nichol McBee, Kennedy Lees, Jesse Dawson, Kenneth Butcher, Paul Vespa, David W. Wright, Penelope M. Keyl, A. David Mendelow, Carlos Kase, Christine Wijman, Marc Lapointe, Sayona John, Richard Thompson, Carol Thom Tags: Research Source Type: research

The Reply
Intracranial bleeding with thrombolytic therapy in elderly patients with pulmonary embolism is far less frequent than death if unstable and thrombolytic therapy is withheld (42.6% mortality if untreated, aged 61-70, and no comorbid conditions vs 9.3% mortality with thrombolytic therapy; 47.0% mortality with comorbid conditions if untreated vs 21.6% if treated). In patients>65 years or with kidney disease, intracranial hemorrhage occurred in 1.4% with thrombolytic therapy. Intracranial hemorrhage with thrombolytic therapy in elderly patients with acute myocardial infarction also occurred in 1.4%. With ≥ 5 risk factors for...
Source: The American Journal of Medicine - October 22, 2013 Category: Journals (General) Authors: Paul D. Stein, Fadi Matta Tags: Letters Source Type: research

Drug for Clot in Lung Helps -- at a Price (CME/CE)
(MedPage Today) -- A shot of thrombolytic therapy substantially improved outcomes in intermediate-risk pulmonary embolism in a randomized trial, but the improvement came at a price in bleeding and stroke that is likely to keep acceptance low.
Source: MedPage Today Emergency Medicine - April 9, 2014 Category: Emergency Medicine Source Type: news

Life-saving systemic thrombolysis in a patient with massive pulmonary embolism and a recent hemorrhagic cerebrovascular accident.
We present the case of a 60-year-old woman in whom massive pulmonary embolism led to cardiac arrest with pulseless electrical activity. Eight weeks earlier, she had sustained a hemorrhagic cerebrovascular accident-a classic absolute contraindication to thrombolytic therapy. Despite this practice guideline, we administered tissue plasminogen activator systemically in order to save the patient's life. This therapy did not evoke intracranial bleeding, and the patient was eventually discharged from the hospital. Until guidelines specific to venous thromboembolic disease are developed, we think that the current contraindication...
Source: Texas Heart Institute Journal - April 1, 2014 Category: Cardiology Authors: Bottinor W, Turlington J, Raza S, Roberts CS, Malhotra R, Jovin IS, Abbate A Tags: Tex Heart Inst J Source Type: research

Evidence suggests dabigatran is an effective and safe treatment for patients with VTE requiring early parenteral therapy
Commentary on: Schulman S, Kakkar AK, Goldhaber SZ, et al.. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis. Circulation 2014;129:764–72. Context Until recently, an initial course of parenteral anticoagulation followed by vitamin K antagonist (VKA) was the standard of care for the treatment of venous thromboembolism (VTE). In the past few years, direct oral anticoagulants (DOAC) have been found to be non-inferior to VKA.1–3 The RE-COVER study found dabigatran to be non-inferior to warfarin, with a reduced risk for clinically relevant bleeding.4 In order to confirm these...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Granziera, S., Cohen, A. T. Tags: Drugs: cardiovascular system, Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests Therapeutics Source Type: research