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Intravenous Alteplase for Acute Stroke and Pulmonary Embolism in a Patient With Recent Abdominoplasty
Conclusions: Interdisciplinary collaboration can successfully inform the decision to treat acute ischemic stroke with IV alteplase in the setting of recent major surgery.
Source: The Neurologist - June 24, 2017 Category: Neurology Tags: Case Report/Case Series Source Type: research

Choosing the Correct “-ase” in Acute Ischemic Stroke: Alteplase, Tenecteplase, and Reteplase
Alteplase is a tissue plasminogen activator approved for treating acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute massive pulmonary embolism. Two additional tissue plasminogen activators, tenecteplase and reteplase, are also approved for AMI treatment. However, neither tenecteplase nor reteplase is approved for AIS treatment. The U.S. Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can lead to potential overdose. Primary factors contributing to medication errors include use of the abbreviat...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Myocardial Wall Rupture Following tPA Administration: A Case Report and Review of the Literature (P3.270)
Conclusions:Although the frequency of pericarditis, mural hemorrhage and subsequent myocardial rupture after MI is declining following PCI, clinicians should be mindful of this potential complication in tPA treated patients with recent MI. Further, cardiac wall rupture should be considered in patients who develop acute hypotension and bradycardia following tPA administration. The current literature is limited and insufficient to provide generalizable guidance on managing AIS patients with recent MI.Disclosure: Dr. Neu has nothing to disclose. Dr. Albright has nothing to disclose. Dr. Lyerly has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Neu, M., Albright, K., Lyerly, M. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Thrombolysis with Reteplase in Acute Pulmonary Embolism
ConclusionsDouble bolus reteplase given with heparin is effective in the treatment of high, intermediate risk pulmonary embolism with minimal risk of bleeding.
Source: Indian Heart Journal - September 22, 2019 Category: Cardiology Source Type: research

Clinical Pharmacokinetics and Pharmacodynamics of Desmoteplase
AbstractDesmoteplase is a bat (Desmodus rotundus) saliva-derived fibrinolytic enzyme resembling a urokinase and tissue plasminogen activator. It is highly dependent on fibrin and has some neuroprotective attributes. Intravenous administration of desmoteplase is safe and well tolerated in healthy subjects. Plasma fibrinolytic activity is linearly related to its blood concentration, its terminal elimination half-life ranges from 3.8 to 4.92  h (50 vs. 90 μg/kg dose). Administration of desmoteplase leads to transitory derangement of fibrinogen, D-dimer, alpha2-antiplasmin, and plasmin and antiplasmin complex which normaliz...
Source: European Journal of Drug Metabolism and Pharmacokinetics - December 11, 2021 Category: Drugs & Pharmacology Source Type: research

Bacterial staphylokinase as a promising third-generation drug in the treatment for vascular occlusion.
Abstract Vascular occlusion is one of the major causes of mortality and morbidity. Blood vessel blockage can lead to thrombotic complications such as myocardial infarction, stroke, deep venous thrombosis, peripheral occlusive disease, and pulmonary embolism. Thrombolytic therapy currently aims to rectify this through the administration of recombinant tissue plasminogen activator. Research is underway to design an ideal thrombolytic drug with the lowest risk. Despite the potent clot lysis achievable using approved thrombolytic drugs such as alteplase, reteplase, streptokinase, tenecteplase, and some other fibrinoly...
Source: Molecular Biology Reports - October 31, 2019 Category: Molecular Biology Authors: Nedaeinia R, Faraji H, Javanmard SH, Ferns GA, Ghayour-Mobarhan M, Goli M, Mashkani B, Nedaeinia M, Haghighi MHH, Ranjbar M Tags: Mol Biol Rep Source Type: research

Reduced-dose intravenous thrombolysis for acute intermediate high-risk pulmonary embolism: Rationale and design of the PEITHO-3 trial
Thromb Haemost. 2021 Sep 24. doi: 10.1055/a-1653-4699. Online ahead of print.ABSTRACTIntermediate high-risk pulmonary embolism (PE) is characterised by right ventricular (RV) dysfunction and elevated circulating cardiac troponin levels despite apparent haemodynamic stability at presentation. In these patients, full-dose systemic thrombolysis reduced the risk of haemodynamic decompensation or death but increased the risk of life-threatening bleeding. Reduced-dose thrombolysis may be capable of improving safety while maintaining reperfusion efficacy. The Pulmonary Embolism International Trial (PEITHO)-3 study (EudraCT 2018-0...
Source: Thrombosis and Haemostasis - September 24, 2021 Category: Hematology Authors: Olivier Sanchez Anais Charles-Nelson Walter Ageno Stefano Barco Harald Binder Gilles Chatellier Daniel Duerschmied Klaus Empen Melanie Ferreira Philippe Girard Menno V Huisman David Jim énez Sandrine Katsahian Matija Kozak Mareike Lankeit Nicolas Menevea Source Type: research

Anterograde Injection of Alteplase Salvages Deep Inferior Epigastric Perforator Flap in Reconstructive Breast Surgery
We report the case of a 43-year-old woman who underwent unilateral breast reconstruction with a DIEP flap at our department. Approximately 12 hours postoperatively, an arterial inflow problem was suspected and revision surgery was performed. Peripheral flap perfusion remained absent without an obvious cause and distal thrombosis was assumed to be present. Therefore, alteplase was gradually injected into the arterial pedicle in the anterograde direction just distal to the anastomosis while clamping the artery proximally. About 3 hours after selective flap thrombolysis, microcirculation of the flap was successfully restored ...
Source: Plastic and Reconstructive Surgery � Global Open - June 1, 2022 Category: Cosmetic Surgery Tags: Breast: Case Report Source Type: research

Identification, characterization, and engineering of glycosylation in thrombolyticsa
Biotechnol Adv. 2023 May 12:108174. doi: 10.1016/j.biotechadv.2023.108174. Online ahead of print.ABSTRACTCardiovascular diseases, such as myocardial infarction, ischemic stroke, and pulmonary embolism, are the most common causes of disability and death worldwide. Blood clot hydrolysis by thrombolytic enzymes and thrombectomy are key clinical interventions. The most widely used thrombolytic enzyme is alteplase, which has been used in clinical practice since 1986. Another clinically used thrombolytic protein is tenecteplase, which has modified epitopes and engineered glycosylation sites, suggesting that carbohydrate modifica...
Source: Adv Data - May 14, 2023 Category: Epidemiology Authors: Martin Toul Veronika Slonkova Jan Mican Adam Urminsky Maria Tomkova Erik Sedlak David Bednar Jiri Damborsky Lenka Hernychova Zbynek Prokop Source Type: research

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