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Specialty: Neurology
Drug: Activase
Education: Study

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Total 294 results found since Jan 2013.

Predictors of symptomatic intracranial haemorrhage in off ‐label thrombolysis: an analysis of the safe implementation of treatments in stroke registry
ConclusionsThrombolysis appears to be safe with regard to SICH for most of the off‐label criteria, especially for minor stroke, but is risky in patients with high blood pressure. Individual risk–benefit evaluation should be performed.
Source: European Journal of Neurology - December 2, 2017 Category: Neurology Authors: S. Mundiyanapurath, K. Hees, N. Ahmed, N. Wahlgren, L. Uhlmann, M. Kieser, P. A. Ringleb, W. Hacke, S. Nagel Tags: Original Article Source Type: research

Incidental Thrombotic Thrombocytopenic Purpura during Acute Ischemic Stroke and Thrombolytic Treatment
In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented.
Source: Journal of Stroke and Cerebrovascular Diseases - November 28, 2017 Category: Neurology Authors: İbrahim Acır, Hacı Ali Erdoğan, Vildan Yayla, Nilay Taşdemir, Murat Çabalar Tags: Case Report Source Type: research

Thrombolytic Therapy of Acute Ischemic Stroke during Early Pregnancy
Thrombolytic treatment (recombinant tissue plasminogen activator [rt-PA]) has established efficacy in acute ischemic stroke, but pregnancy has been an exclusion criterion for all clinical trials that validated alteplase in acute stroke, so our knowledge about its use in this condition is limited.Herein we report the successful use of intravenous rt-PA thrombolysis, uncomplicated by neither hemorrhage development nor other complication in a woman who was 13 weeks pregnant with acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 28, 2017 Category: Neurology Authors: Anne Landais, Hugo Chaumont, Rachel Dellis Tags: Case Studies Source Type: research

Incidental Thrombotic Thrombocytopenic Purpura during Acute Ischemic Stroke and Thrombolytic Treatment
In this study, a patient with AIS and thrombotic thrombocytopenic purpura (TTP) symptoms during thrombolytic treatment was presented.
Source: Journal of Stroke and Cerebrovascular Diseases - November 28, 2017 Category: Neurology Authors: İbrahim Acır, Hacı Ali Erdoğan, Vildan Yayla, Nilay Taşdemir, Murat Çabalar Tags: Case Report Source Type: research

Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Purpose—Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment.Methods—A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. The documen...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Shadi Yaghi, Joshua Z. Willey, Brett Cucchiara, Joshua N. Goldstein, Nicole R. Gonzales, Pooja Khatri, Louis J. Kim, Stephan A. Mayer, Kevin N. Sheth, Lee H. Schwamm Tags: Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

Ischemic core thresholds change with time to reperfusion: A case control study
This article is protected by copyright. All rights reserved.
Source: Annals of Neurology - November 1, 2017 Category: Neurology Authors: Andrew Bivard, Tim Kleinig, Ferdinand Miteff, Kenneth Butcher, Longting Lin, Christopher Levi, Mark Parsons Tags: Research Article Source Type: research

Safety of Intravenous Thrombolysis in Chronic Intracranial Hemorrhage: A Five-Year Multicenter Study
Although the recently updated U.S. alteplase label removed “history of intracranial hemorrhage (ICH)” as a contraindication, there are very limited data on the safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients with chronic ICH. We sought to evaluate IVT safety in AIS patients with a history of ICH.
Source: Journal of Stroke and Cerebrovascular Diseases - October 31, 2017 Category: Neurology Authors: Ramin Zand, Georgios Tsivgoulis, Alireza Sadighi, Mantinderpreet Singh, Michael McCormack, Shima Shahjouei, Nitin Goyal, Nariman Noorbakhsh-Sabet, Anne W. Alexandrov, Andrei V. Alexandrov Source Type: research

Icatibant as a Potential Treatment of Life-Threatening Alteplase-Induced Angioedema
Severe orolingual angioedema is a life-threatening complication of alteplase treatment for acute ischemic stroke that occurs during alteplase infusion or in the first 2 hours afterward. Currently, there are no proven therapies, although glucocorticoids, antihistamines, and adrenaline are sometimes used. Intubation is required if significant airway compromise supervenes. The incidence is .2%-5.1%, and risk factors include treatment with angiotensin-converting enzyme inhibitors and total insular infarcts.
Source: Journal of Stroke and Cerebrovascular Diseases - October 30, 2017 Category: Neurology Authors: Edmund Cheong, Lizzie Dodd, William Smith, Timothy Kleinig Tags: Case Studies Source Type: research

Safety and preliminary efficacy of intravenous tirofiban in acute ischemic stroke patient without arterial occlusion on neurovascular imaging studies
In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study.
Source: Journal of the Neurological Sciences - October 26, 2017 Category: Neurology Authors: Lu Lin, Wei Li, Cheng-Chun Liu, Ya Wu, Shu-Han Huang, Xiao-Shu Li, Chun-Rong Liang, Huan Wang, Li-Li Zhang, Zhi-Qiang Xu, Yan-Jiang Wang, Wuwei Feng, Meng Zhang Source Type: research

Outcomes of Endovascular Thrombectomy with and without Thrombolysis for Acute Large Artery Ischaemic Stroke at a Tertiary Stroke Centre
Conclusion: Our study highlights the relatively large proportion of patients suitable for EVT who have a contraindication to alteplase and raises the hypothesis that adding alteplase to successful EVT may not be necessary to optimize functional outcome. The results are consistent with observational data from other endovascular centres and support a randomised controlled trial of EVT versus EVT with bridging alteplase.Cerebrovasc Dis Extra 2017;7:95 –102
Source: Cerebrovascular Diseases Extra - October 25, 2017 Category: Neurology Source Type: research

Which imaging before reperfusion strategy?
Authors: Olivot JM Abstract The ischemic penumbra is a transient and potentially reversible condition. Therefore, infarct progression and its counterpart penumbral salvage are highly variable and result from the interaction of 3 major factors: collateral flow, revascularization delay and success. Multimodal brain imaging now offers in clinical practice an exhaustive characterization of the acute ischemic injury: vessel site occlusion, infarction/critical hypoperfusion volume, and collateral flow. From 1995 to 2015, IV alteplase administered within 4.5hours after the onset of acute BI diagnosed by the absence of hem...
Source: Revue Neurologique - October 20, 2017 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Outcome after stroke thrombolysis in patients >80 years treated within 3 hours vs >3-4.5 hours
Conclusions: In this observational study, unselected patients >80 years of age treated with IVT after 3 hours vs earlier had a slightly higher rate of SICH and similar unadjusted functional outcome but poorer adjusted outcome. The absolute difference between the treatment groups is small, and elderly patients should not be denied IVT in the later time window solely because of age without other contraindications.
Source: Neurology - October 9, 2017 Category: Neurology Authors: Ahmed, N., Lees, K. R., Ringleb, P. A., Bladin, C., Collas, D., Toni, D., Ford, G. A., And the SITS Investigators Tags: All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions Source Type: research

Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke Brief Report
Background and Purpose—Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study).Methods—A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe R...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Susan J. Carr, Xia Wang, Veronica V. Olavarria, Pablo M. Lavados, Jorge A. Rodriguez, Jong S. Kim, Tsong-Hai Lee, Richard I. Lindley, Octavio M. Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K. Sharma, Mark Woodward, John Chalmers, Craig S. Anderson, Tags: Clinical Studies, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research

Reliability, Reproducibility and Prognostic Accuracy of the Alberta Stroke Program Early CT Score on CT Perfusion and Non-Contrast CT in Hyperacute Stroke
Background: Alberta Stroke Program Early CT Score (ASPECTS) assesses early ischemic change on non-contrast CT (NCCT). We hypothesised that assessing ASPECTS regions on CT Perfusion (CTP) rather than NCCT would improve inter-rater agreement and prognostic accuracy, particularly in patients presenting early after stroke onset.Methods: Ischemic stroke patients treated with intravenous alteplase from 2009 to 2014 at our institution were included in this study. Inter-rater agreement and prognostic accuracy of ASPECTS across modalities were analysed by the time between stroke onset and initial NCCT, dichotomized 1st quartile ver...
Source: Cerebrovascular Diseases - August 15, 2017 Category: Neurology Source Type: research