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Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis
Publication date: Available online 8 June 2016 Source:The Lancet Neurology Author(s): William N Whiteley, Jonathan Emberson, Kennedy R Lees, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Rüdiger von Kummer, Maarten G Lansberg, Richard I Lindley, Patrick Lyden, Jean Marc Olivot, Mark Parsons, Danilo Toni, Kazunori Toyoda, Nils Wahlgren, Joanna Wardlaw, Gregory J del Zoppo, Peter Sandercock, Werner Hacke, Colin Baigent Background Randomised trials have shown that alteplase impr...
Source: The Lancet Neurology - June 8, 2016 Category: Neurology Source Type: research

Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study
This study is registered with ClinicalTrials.gov, number NCT01472926. Findings Between Jan 1, 2012, and Sept 7, 2013, 355 patients were screened, of whom 157 were eligible for intravenous thrombolysis, and 104 patients were enrolled. 52 were assigned to the alteplase group and 52 to tenecteplase. Of 71 patients (35 assigned tenecteplase and 36 assigned alteplase) contributing to the primary endpoint, no significant differences were noted for percentage of penumbral salvaged (68% [SD 28] for the tenecteplase group vs 68% [23] for the alteplase group; mean difference 1·3% [95% CI −9·6 to 12·1]; p=0·81). Neither incide...
Source: The Lancet Neurology - February 26, 2015 Category: Neurology Source Type: research

Association between brain imaging signs, early and late outcomes, and response to intravenous alteplase after acute ischaemic stroke in the third International Stroke Trial (IST-3): secondary analysis of a randomised controlled trial
Publication date: Available online 27 March 2015 Source:The Lancet Neurology Background Brain scans are essential to exclude haemorrhage in patients with suspected acute ischaemic stroke before treatment with alteplase. However, patients with early ischaemic signs could be at increased risk of haemorrhage after alteplase treatment, and little information is available about whether pre-existing structural signs, which are common in older patients, affect response to alteplase. We aimed to investigate the association between imaging signs on brain CT and outcomes after alteplase. Methods IST-3 was a multicentre, randomised ...
Source: The Lancet Neurology - March 27, 2015 Category: Neurology Source Type: research

Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Luis San Román, Bijoy K Menon, Jordi Blasco, María Hernández-Pérez, Antoni Dávalos, Charles B L M Majoie, Bruce C V Campbell, Francis Guillemin, Hester Lingsma, René Anxionnat, Jonathan Epstein, Jeffrey L Saver, Henk Marquering, John H Wong, Demetrius Lopes, Gernot Reimann, Hubert Desal, Diederik W J Dippel, Shelagh Coutts, Richard du Mesnil de RochemontSummaryBackgroundEvidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the associat...
Source: The Lancet Neurology - September 19, 2018 Category: Neurology Source Type: research

Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Publication date: Available online 30 April 2015 Source:The Lancet Neurology Author(s): Gregory W Albers , Rüdiger von Kummer , Thomas Truelsen , Jens-Kristian S Jensen , Gabriela M Ravn , Bjørn A Grønning , Hugues Chabriat , Ku-Chou Chang , Antonio E Davalos , Gary A Ford , James Grotta , Markku Kaste , Lee H Schwamm , Ashfaq Shuaib Background Current treatment of ischaemic stroke with thrombolytic therapy is restricted to 3–4·5 h after symptom onset. We aimed to assess the safety and efficacy of desmoteplase, a fibrin-dependent plasminogen activator, given between 3 h and 9 h after symptom onset in patients with ...
Source: The Lancet Neurology - May 1, 2015 Category: Neurology Source Type: research

Deferoxamine mesylate in patients with intracerebral haemorrhage (i-DEF): a multicentre, randomised, placebo-controlled, double-blind phase 2 trial
Publication date: Available online 18 March 2019Source: The Lancet NeurologyAuthor(s): Magdy Selim, Lydia D Foster, Claudia S Moy, Guohua Xi, Michael D Hill, Lewis B Morgenstern, Steven M Greenberg, Michael L James, Vineeta Singh, Wayne M Clark, Casey Norton, Yuko Y Palesch, Sharon D Yeatts, Monica Dolan, Erlinda Yeh, Kevin Sheth, Kimberly Kunze, Susanne Muehlschlegel, Iryna Nieto, Jan ClaassenSummaryBackgroundIron from haemolysed blood is implicated in secondary injury after intracerebral haemorrhage. We aimed to assess the safety of the iron chelator deferoxamine mesylate in patients with intracerebral haemorrhage and to...
Source: The Lancet Neurology - March 19, 2019 Category: Neurology Source Type: research

Blood pressure control and clinical outcomes in acute intracerebral haemorrhage: a preplanned pooled analysis of individual participant data
Publication date: September 2019Source: The Lancet Neurology, Volume 18, Issue 9Author(s): Tom J Moullaali, Xia Wang, Reneé H Martin, Virginia B Shipes, Thompson G Robinson, John Chalmers, Jose I Suarez, Adnan I Qureshi, Yuko Y Palesch, Craig S AndersonSummaryBackgroundUncertainty persists over the effects of blood pressure lowering in acute intracerebral haemorrhage. We aimed to combine individual patient-level data from the two largest randomised controlled trials of blood pressure lowering strategies in patients with acute intracerebral haemorrhage to determine the strength of associations between key measures of systo...
Source: The Lancet Neurology - August 8, 2019 Category: Neurology Source Type: research