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Source: The Lancet Neurology
Condition: Stroke
Drug: Activase
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Total 16 results found since Jan 2013.
Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial
Publication date: April 2019Source: The Lancet Neurology, Volume 18, Issue 4Author(s): Andrei V Alexandrov, Martin Köhrmann, Lauri Soinne, Georgios Tsivgoulis, Andrew D Barreto, Andrew M Demchuk, Vijay K Sharma, Robert Mikulik, Keith W Muir, Gordon Brandt, John Alleman, James C Grotta, Christopher R Levi, Carlos A Molina, Maher Saqqur, Dimitris Mavridis, Theodora Psaltopoulou, Milan Vosko, Jochen B Fiebach, Pitchaiah MandavaSummaryBackgroundPulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed ...
Source: The Lancet Neurology - March 16, 2019 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
Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial
This study is registered with ClinicalTrials.gov, number NCT01949948. Findings Between Sept 1, 2012, and Sept 30, 2016, 1107 patients met the inclusion criteria and seven patients were excluded because informed consent was withdrawn or eligibility for thrombolytic treatment was reconsidered. 1100 patients were randomly assigned to the tenecteplase (n=549) or alteplase (n=551) groups. The median age of participants was 77 years (IQR 64–79) and the median National Institutes of Health Stroke Scale score at baseline was 4 points (IQR 2–8). A final diagnosis other than ischaemic stroke or transient ischaemic attack was fou...
Source: The Lancet Neurology - August 3, 2017 Category: Neurology Source Type: research
Safety and efficacy of thrombectomy in acute ischaemic stroke (REVASCAT): 1-year follow-up of a randomised open-label trial
We report the results of the prespecified 12-month analysis of the REVASCAT trial. Methods Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone. The main secondary outcome measure at 1 year follow-up was disability, measured using the modified Rankin Scale (mRS), ranging from 0 (no symptoms) to 6 (death) with categories 5 (severe disability) and 6 (death) collapsed into one category (severe disability or death), analysed as the d...
Source: The Lancet Neurology - March 16, 2017 Category: Neurology Source Type: research
Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial
Publication date: Available online 23 August 2016 Source:The Lancet Neurology Author(s): Serge Bracard, Xavier Ducrocq, Jean Louis Mas, Marc Soudant, Catherine Oppenheim, Thierry Moulin, Francis Guillemin Background Intravenous thrombolysis with alteplase alone cannot reperfuse most large-artery strokes. We aimed to determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in patients with acute ischaemic stroke. Methods THRACE is a randomised controlled trial done in 26 centres in France. Patients aged 18–80 years with acute ischaemic stroke and proximal cerebral artery...
Source: The Lancet Neurology - August 23, 2016 Category: Neurology Source Type: research
Effects of alteplase on survival after ischaemic stroke (IST-3): 3 year follow-up of a randomised, controlled, open-label trial
We report the effect of intravenous alteplase on long-term survival after ischaemic stroke of participants in the Third International Stroke Trial (IST-3). Methods In IST-3, done at 156 hospitals in 12 countries (Australia, Europe, and the UK), participants (aged >18 years) were randomly assigned with a telephone voice-activated or web-based system in a 1:1 ratio to treatment with intravenous 0·9 mg/kg alteplase plus standard care or standard care alone within 6 h of ischaemic stroke. We followed up participants in the UK and Scandinavia (Sweden and Norway) for survival up to 3 years after randomisation using data...
Source: The Lancet Neurology - July 19, 2016 Category: Neurology Source Type: research
Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study
This study is registered with ClinicalTrials.gov, number NCT02358772. Findings Between Feb 5, 2011, and March 5, 2015, 427 patients were treated within the STEMO vehicle and their data were entered into a pre-hospital registry. 505 patients received conventional care and their data were entered into an in-hospital thrombolysis registry. Of these, 305 patients in the STEMO group and 353 in the conventional care group met inclusion criteria and were included in the analysis. 161 (53%) patients in the STEMO group versus 166 (47%) in the conventional care group had an mRS score of 1 or lower (p=0·14). Compared with conventio...
Source: The Lancet Neurology - July 15, 2016 Category: Neurology Source Type: research
Alteplase in acute ischaemic stroke: no time to slow down
Publication date: Available online 8 June 2016 Source:The Lancet Neurology Author(s): Stefan Kiechl, Johann Willeit
Source: The Lancet Neurology - June 8, 2016 Category: Neurology Source Type: research
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
Neuroprotection in acute stroke: targeting excitotoxicity, oxidative and nitrosative stress, and inflammation
Publication date: Available online 11 May 2016 Source:The Lancet Neurology Author(s): Ángel Chamorro, Ulrich Dirnagl, Xabier Urra, Anna M Planas Treatments for acute ischaemic stroke continue to evolve after the superior value of endovascular thrombectomy was confirmed over systemic thrombolysis. Unfortunately, numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischaemic stroke, making the search for new treatments imperative. Increased awareness of the relevance of rigorous preclinical testing, and appropriate selection of study participants, might overcome the barriers to progress...
Source: The Lancet Neurology - May 11, 2016 Category: Neurology Source Type: research
Endovascular stent thrombectomy: the new standard of care for large vessel ischaemic stroke
Publication date: Available online 25 June 2015 Source:The Lancet Neurology Author(s): Bruce C V Campbell , Geoffrey A Donnan , Kennedy R Lees , Werner Hacke , Pooja Khatri , Michael D Hill , Mayank Goyal , Peter J Mitchell , Jeffrey L Saver , Hans-Christoph Diener , Stephen M Davis Background Results of initial randomised trials of endovascular treatment for ischaemic stroke, published in 2013, were neutral but limited by the selection criteria used, early-generation devices with modest efficacy, non-consecutive enrolment, and treatment delays. Recent developments In the past year, six positive trials of endovascular t...
Source: The Lancet Neurology - June 26, 2015 Category: Neurology Source Type: research
Future directions of acute ischaemic stroke therapy
Publication date: July 2015 Source:The Lancet Neurology, Volume 14, Issue 7 Author(s): Marc Fisher , Jeffrey L Saver For several years, the only therapy with proven efficacy for acute ischaemic stroke was alteplase, which is approved for use within 4·5 h after stroke onset in many countries, but only within 3 h in the USA. However, the recanalisation rate with alteplase is modest. Several trials have shown substantial clinical benefit of neurothrombectomy within 6 h of ischaemic stroke onset, which has initiated a new era of acute stroke therapy. As neurothrombectomy becomes part of standard practice, additional trials ...
Source: The Lancet Neurology - June 9, 2015 Category: Neurology Source Type: research
Brain CT signs and the effect of alteplase after stroke
Publication date: Available online 27 March 2015 Source:The Lancet Neurology Author(s): Vincent Larrue
Source: The Lancet Neurology - March 27, 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
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
