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Condition: Hemorrhagic Stroke
Drug: Activase

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Total 351 results found since Jan 2013.

Editorial Thrombolysis for stroke: clinical judgment at its apogee
In the Correspondence section of today's Lancet, we publish a selection of letters challenging the report by Jonathan Emberson and colleagues on the effect of treatment delay, age, and stroke severity on the effects of thrombolysis with alteplase for acute ischaemic stroke. Emberson and colleagues concluded from their meta-analysis of 6756 patients that despite early increases in fatal intracranial haemorrhage, alteplase improves the overall likelihood of a good stroke outcome at 3–6 months when delivered within 4·5 h of the initial stroke symptoms, with earlier treatment increasing proportional benefit, irrespective of...
Source: LANCET - April 10, 2015 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research

Intravenous thrombolysis is more safe and effective for posterior circulation stroke: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
Abstract: We aimed to compare the safety and efficacy of intravenous thrombolysis (IVT) with alteplase for anterior circulation stroke (ACS) and posterior circulation stroke (PCS). From a large multicenter prospective registry—the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database—all patients who received IVT within 4.5 hours after stroke onset was reviewed. According to the clinical presentations and imaging findings, the eligible patients were divided into ACS and PCS groups. The safety and efficacy outcome measures included post-IVT symptomatic intracranial hemorrhage (sICH), paren...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Short- and Long-Term Reduction of Door-to-Needle Time in Thrombolysis for Acute Stroke.
Conclusions: We were able to decrease our DTN time for acute stroke thrombolysis by implementing relatively simple modifications and these improvements persisted over time. PMID: 27998323 [PubMed - as supplied by publisher]
Source: The Canadian Journal of Neurological Sciences - December 20, 2016 Category: Neurology Authors: Chen BY, Moussaddy A, Keezer MR, Deschaintre Y, Poppe AY Tags: Can J Neurol Sci Source Type: research

Thrombolytic Treatment for Ischaemic Stroke: Could the Crisis of Confidence Have Been Avoided by Better Analysis of Trial Data?
AbstractIn many countries, thrombolysis with intravenous alteplase has become a central part of acute stroke care in recent years, requiring radical restructuring of services. However, a significant minority of emergency and stroke physicians have always had serious doubts about the safety and efficacy of thrombolytic treatment, and in 2015 these prompted a major review of the licensing status of alteplase by the UK regulatory authorities. Subsequent dramatic headlines and media stories have called into question the integrity of researchers and clinicians and undermined public faith in medical research. How did this situat...
Source: Drugs and Aging - January 23, 2017 Category: Geriatrics Source Type: research

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

Relevance of the Updated Food and Drug Administration Alteplase Label for Acute Ischemic Stroke: The Estimated Impact and Current Guidelines.
Abstract In 2015, the Food and Drug Administration updated the contraindications for the use of alteplase in acute ischemic stroke (AIS), potentially creating a greater impact on treatment. A history of intracranial hemorrhage and recent stroke within 3 months were removed as contraindications, increasing the number of patients eligible for alteplase. The aim of this commentary is to call attention to the updates and discuss them relative to current American Heart Association/American Stroke Association guidelines. Additionally, we estimate the clinical impact of the updates by analyzing AIS admissions to a large-...
Source: The Annals of Pharmacotherapy - January 1, 2018 Category: Drugs & Pharmacology Authors: Shiue HJ, Albright KC, Sands KA Tags: Ann Pharmacother Source Type: research

Intravenous Alteplase for Mild Nondisabling Acute Ischemic Stroke
Treatment of patients with stroke has changed substantially during the past 25 years. In 1995, the NINDS rt-PA trial showed among selected patients with acute ischemic stroke who were treated with intravenous alteplase within 3 hours of known stroke onset or last known well time had reduced disability at 3 months. In 2008, the ECASS III trial demonstrated benefit of intravenous alteplase among selected patients treated up to 4.5 hours after known stroke onset or last known well time. Benefit from alteplase treatment occurred despite higher rates of symptomatic intracranial hemorrhage compared with placebo (6.4% vs 0.6% in ...
Source: JAMA - July 10, 2018 Category: General Medicine Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

A spontaneous cervical epidural hematoma mimicking a stroke - A case report.
Conclusion: tPA treatment is frequently used as first-line therapy for acute ischemic stroke. Therefore, physicians should be aware of the potential for the SCEH in patients presenting with hemiparesis, as tPA administration may increase cervical hematoma leading to clinical deterioration. With this case, we intended to warn about SCEH as a rare but possible entity, since its early recognition and prompt clinical intervention may improve neurological outcomes. PMID: 32637210 [PubMed]
Source: Surgical Neurology International - July 10, 2020 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Low-Dose vs. Standard-Dose Intravenous Alteplase in Bridging Therapy Among Patients With Acute Ischemic Stroke: Experience From a Stroke Center in Vietnam
Conclusion: In the present study, patients with low-dose alteplase before MTE were found to achieve comparable clinical outcomes compared to those receiving standard-dose alteplase bridging with MTE. The findings suggest potential benefits of low-dose alteplase in bridging therapy for Asian populations, but this needs to be confirmed by further clinical trials.
Source: Frontiers in Neurology - April 9, 2021 Category: Neurology Source Type: research

Thrombolytic strategies for ischemic stroke in the thrombectomy era
J Thromb Haemost. 2021 Apr 9. doi: 10.1111/jth.15336. Online ahead of print.ABSTRACTTwenty-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. In the present review, we will present the last clinical an...
Source: Thrombosis and Haemostasis - April 9, 2021 Category: Hematology Authors: Maxime Gauberti Sara Martinez de Lizarrondo Denis Vivien Source Type: research

Disparities between Asian and Non-Asian Thrombolyzed Acute Ischemic Stroke Patients in the Enhanced Control of Hypertension and Thrombolysis Stroke Trial
Conclusions: Within the context of an international clinical trial of thrombolyzed AIS patients, demography, risk factors, management, and odds of early neurological deterioration and ICH, all differ between Asian and non-Asian participants. However, patterns of functional recovery are similar between these major regional groups.Cerebrovasc Dis
Source: Cerebrovascular Diseases - June 21, 2021 Category: Neurology Source Type: research

High-resolution CT with arch/neck/head CT angiography on a mobile stroke unit
Conclusions MSU use of advanced imaging including multiphasic head/neck CTA is feasible, offers high LVO yield and enables full ED bypass.
Source: Journal of NeuroInterventional Surgery - May 13, 2022 Category: Neurosurgery Authors: Alexandrov, A. W., Arthur, A. S., Bryndziar, T., Swatzell, V. M., Dusenbury, W., Hardage, K., McCormick, S., Rhudy, J. P., Maleki, A. H. Z., Singh, S., Krishnaiah, B., Nearing, K., Rubin, M. N., Malkoff, M. D., McKendry, C., Metter, E. J., Alexandrov, A. Tags: Neuroimaging Source Type: research

E-048 Antithrombotics for emergent stenting in acute stroke
ConclusionTirofiban continuous infusion is a safe and possibly effective strategy for emergent stenting in acute ischemic stroke.Disclosures S. Lahoti: None. K. Limaye: None. C. Zevallos: None. K. Dlouhy: None. M. Hayakawa: None. E. Samaniego: None. D. Hasan: None. S. Ortega: 2; C; Medtronic, Stryker Neurovascular, Microvention. C. Derdeyn: 1; C; Siemens Healthineers. 4; C; Euphrates Vascular, Inc. 6; C; DSMB: Penumbra (MIND), NoNO (ESCAPE NA1 and FRONTIER).
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lahoti, S., Limaye, K., Zevallos, C., Dlouhy, K., Hayakawa, M., Samaniego, E., Hasan, D., Ortega, S., Derdeyn, C. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research