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Specialty: Neurology
Drug: Activase
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Total 294 results found since Jan 2013.

The role of uric acid as a potential neuroprotectant in acute ischemic stroke: a review of literature
Abstract Uric acid (UA), a product of purine metabolism, is a kind of powerful endogenous antioxidant which may increase in many oxidative stress situations such as stroke. Some studies have found that UA is a predictor for stroke by mechanisms involved in development. There are some controversies about whether it is an independent effect of UA or an epiphenomenon. UA has been widely concerned for its neuroprotective effect as an antioxidant. In some experimental models of acute ischemic stroke, UA levels are associated with better functional recovery because of its synergistic effect with alteplase. In this re...
Source: Neurological Sciences - March 13, 2015 Category: Neurology Source Type: research

Articles Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study
Neurological and radiological outcomes did not differ between the tenecteplase and alteplase groups. Evaluation of tenecteplase in larger trials of patients with acute stroke seems warranted.
Source: Lancet Neurology - February 26, 2015 Category: Neurology Authors: Xuya Huang, Bharath Kumar Cheripelli, Suzanne M Lloyd, Dheeraj Kalladka, Fiona Catherine Moreton, Aslam Siddiqui, Ian Ford, Keith W Muir Tags: Articles 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

Uric acid improves glucose‐driven oxidative stress in human ischemic stroke
This article is protected by copyright. All rights reserved.
Source: Annals of Neurology - January 27, 2015 Category: Neurology Authors: Sergio Amaro, Laura Llull, Arturo Renú, Carlos Laredo, Belén Perez, Elisabet Vila, Ferran Torres, Anna M. Planas, Ángel Chamorro Tags: Research Article Source Type: research

In Context News in brief
A new study shows that intra-arterial treatment given within 6 h after stroke onset can lead to an increase in functional independence in daily life after 3 months, without an increase in mortality, in patients with proximal arterial occlusion in the anterior circulation. The MR CLEAN investigators did a phase 3, multicentre, randomised trial of intra-arterial treatment for acute ischaemic stroke in 500 patients (mean age 65 years, range 23–96) with a radiologically confirmed proximal vessel occlusion; 445 (89%) patients had received intravenous alteplase before randomisation.
Source: Lancet Neurology - January 12, 2015 Category: Neurology Tags: In Context Source Type: research

Thrombolysis and clinical outcome in patients with stroke after implementation of the Tyrol Stroke Pathway: a retrospective observational study
Publication date: Available online 28 November 2014 Source:The Lancet Neurology Author(s): Johann Willeit , Theresa Geley , Johannes Schöch , Heinrich Rinner , Andreas Tür , Hans Kreuzer , Norbert Thiemann , Michael Knoflach , Thomas Toell , Raimund Pechlaner , Karin Willeit , Natalie Klingler , Silvia Praxmarer , Michael Baubin , Gertrud Beck , Klaus Berek , Christian Dengg , Klaus Engelhardt , Thomas Erlacher , Thomas Fluckinger , Wilhelm Grander , Josef Grossmann , Hermann Kathrein , Norbert Kaiser , Benjamin Matosevic , Heinrich Matzak , Markus Mayr , Robert Perfler , Werner Poewe , Alexandra Rauter , Gudrun Schoen...
Source: The Lancet Neurology - December 8, 2014 Category: Neurology Source Type: research

Symptomatic intracranial haemorrhage after thrombolysis with adjuvant anticoagulation in basilar artery occlusion
ConclusionsThe risk of sICH was largely determined by extension of ischaemic changes on admission computed tomography. Clinically relevantly, also higher post‐thrombolytic SBP as described earlier and lower perithrombolytic platelet counts do increase the risk, a finding requiring confirmation in other patient series.
Source: European Journal of Neurology - December 1, 2014 Category: Neurology Authors: T. Sairanen, D. Strbian, R. Ruuskanen, H. Silvennoinen, O. Salonen, P. J. Lindsberg Tags: Original Article Source Type: research

Tissue‐factor‐bearing microparticles (MPs‐TF) in patients with acute ischaemic stroke: the influence of stroke treatment on MPs‐TF generation
ConclusionOur findings suggest that patients with acute ischaemic stroke have increased generation of MPs‐TF. Nevertheless, further studies are needed in order to confirm such inference.
Source: European Journal of Neurology - November 5, 2014 Category: Neurology Authors: M. Świtońska, A. Słomka, W. Sinkiewicz, E. Żekanowska Tags: Original Article Source Type: research

Alteplase in Acute Ischemic Stroke: Putting the Guidelines into Practice
Abstract Intravenous recombinant tissue plasminogen activator (rt-PA or alteplase) is the only approved medical intervention for treatment of acute ischemic stroke within the first hours of symptom onset. In this article, we review the preliminary studies of rt-PA in acute ischemic stroke that led to US FDA approval of its use within 3 h of symptom onset. The studies on rt-PA for use beyond 3 h of symptom onset and future reperfusion therapies are discussed. Overviews of the clinical presentation and treatment of acute ischemic stroke and stroke systems of care are described.
Source: CNS Drugs - October 19, 2014 Category: Neurology Source Type: research

Clinical Trials in Acute Ischemic Stroke
Abstract Acute ischemic stroke (AIS) is a major cause of mortality and disability and remains a serious and significant global health problem. The development of neurovascular protectants to treat AIS successfully has been beset by disappointments and setbacks. Many promising candidates have lacked significant pleiotropic protective activity for brain tissue and cerebral blood vessels in clinical trials, while those with protective activity have had poor bioavailability or high toxicity. Moreover, the majority of agents did not confer significant neurovascular protection or clinical efficacy, as measured by standa...
Source: CNS Drugs - August 27, 2014 Category: Neurology Source Type: research

THrombolysis for Acute Wake‐up and unclear‐onset Strokes with alteplase at 0·6 mg/kg (THAWS) Trial
DiscussionThis trial may help determine if low‐dose alteplase at 0·6 mg/kg should be recommended as a routine clinical strategy for ischemic stroke patients with unclear‐onset time.
Source: International Journal of Stroke - August 4, 2014 Category: Neurology Authors: Masatoshi Koga, Kazunori Toyoda, Kazumi Kimura, Haruko Yamamoto, Makoto Sasaki, Toshimitsu Hamasaki, Takanari Kitazono, Junya Aoki, Kenta Seki, Kazunari Homma, Shoichiro Sato, Kazuo Minematsu, Tags: Protocols Source Type: research

Safety of Standard-dose (.9-mg/kg) Alteplase Intravenous Thrombolysis for Acute Ischemic Stroke in Afro–Caribbeans, French West Indies
Conclusions: The excess hemorrhagic risk after standard-dose alteplase infusion into older Afro–Caribbean patients warrants further study to determine the possible role of cerebral microangiopathy and should be evaluated in different black populations.
Source: Journal of Stroke and Cerebrovascular Diseases - June 23, 2014 Category: Neurology Authors: Nicolas Chausson, Stéphane Olindo, Julien Joux, Martine Saint-Vil, Mathieu Aveillan, Didier Smadja Tags: Original Articles Source Type: research

Orolingual angioedema after alteplase therapy of acute ischaemic stroke: incidence and risk of prior angiotensin‐converting enzyme inhibitor use
ConclusionsThe incidence of rt‐PA‐related OA in the Asian population is lower than that in the Caucasian population. Pre‐stroke use of ACE inhibitors significantly increases the risk of this complication.
Source: European Journal of Neurology - June 9, 2014 Category: Neurology Authors: S.‐Y. Lin, S.‐C. Tang, L.‐K. Tsai, S.‐J. Yeh, Y.‐J. Hsiao, Y.‐W. Chen, K.‐H. Chen, B.‐S. Yip, L.‐J. Shen, F.‐L. Lin Wu, J.‐S. Jeng Tags: Original Article Source Type: research

Comment Endovascular treatment for stroke: when does the window for good outcome close?
The mantra of stroke therapy (time is brain) is underscored once more in The Lancet Neurology in Pooja Khatri and colleagues' analysis of the IMS III study. The primary finding of the IMS III trial was that the combination of endovascular treatment and intravenous alteplase resulted in similar clinical outcomes to intravenous alteplase alone. In the preplanned analysis, Khatri and colleagues' goal was to test the hypothesis that time to angiographic reperfusion would be a key predictor of clinical outcomes in the endovascular treatment group.
Source: Lancet Neurology - May 19, 2014 Category: Neurology Authors: Gregory W Albers Tags: Comment Source Type: research

Comment Uric acid for stroke: glimmer of hope or false dawn?
In The Lancet Neurology, Ángel Chamorro and colleagues present the results of the URICO-ICTUS study of intravenous uric acid administered during alteplase treatment for ischaemic stroke. The primary endpoint—the proportion of patients with excellent outcome according to the modified Rankin Scale (mRS) score at 90 days—was not significantly higher with uric acid than with placebo (adjusted risk ratio 1·23 [95% CI 0·96–1·56]; p=0·099), but the investigators concluded that another, larger trial is warranted.
Source: Lancet Neurology - April 15, 2014 Category: Neurology Authors: Bruce CV Campbell, Stephen M Davis, Geoffrey A Donnan Tags: Comment Source Type: research