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Low-cost alternatives for the management of acute ischemic stroke in low and middle-income countries
Ann Med Surg (Lond). 2021 Oct 21;72:102969. doi: 10.1016/j.amsu.2021.102969. eCollection 2021 Dec.ABSTRACTAcute ischemic stroke (AIS) patients arriving within a suitable time frame are treated with recanalization therapy i.e. intravenous thrombolysis (IVT) with alteplase and/or mechanical thrombectomy (MT). IVT with alteplase is indicated in AIS patients presenting within 4.5 hours of onset regardless of vascular territory involved. MT is indicated in AIS patients presenting within 24 hours of onset with large vessel occlusion in the anterior circulation. However, MT is ludicrously expensive and requires exorbitant setup, ...
Source: Annals of Medicine - January 7, 2022 Category: Internal Medicine Authors: Gaurav Nepal Jayant Kumar Yadav Siddhartha Bhandari Jeevan Gautam Bikram Prasad Gajurel Source Type: research

Intravenous Alteplase for Acute Ischemic Stroke in Taiwan: Can We Expand the National Health Insurance's Reimbursement Criteria?
In conclusion, the non-reimbursement group in Su, et al(3). is a mixture of stroke patients with very heterogeneous characteristics. With the advances of imaging selection modalities and new hyperacute treatment options nowadays, they should no longer be considered as an identical group of patients. We strokologists, as an emerging subspecialists, should devote more in dedicated and individualized selection of stroke patients for appropriate early recanalization therapy to improve their outcomes. Conflict of Interest Disclosure: I received speaker fee from Boehringer Ingelheim for Actilyse® (http://grsp2013.innovarad.tw/2...
Source: Acta Neurologica Taiwanica - July 30, 2017 Category: Neurology Tags: Acta Neurol Taiwan 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

Guidelines for the Intravenous Application of Recombinant Tissue-type Plasminogen Activator (Alteplase), the Second Edition, October 2012: A Guideline From the Japan Stroke Society
In Japan, intravenous alteplase, a recombinant tissue-type plasminogen activator (rt-PA), was approved for an indication of ischemic stroke in 2005 on the basis of the results of a clinical trial with a unique dose of the drug (0.6 mg/kg). The Japan Stroke Society published the guidelines for intravenous application of rt-PA and organized training sessions for proper use all over Japan in an effort to promote the safe, widespread use of intravenous alteplase. Seven years following its approval, clinical experience with intravenous alteplase has accumulated, additional evidence of intravenous alteplase has been found in Jap...
Source: Journal of Stroke and Cerebrovascular Diseases - June 3, 2013 Category: Neurology Authors: Kazuo Minematsu, Kazunori Toyoda, Teruyuki Hirano, Kazumi Kimura, Rei Kondo, Etsuro Mori, Jyoji Nakagawara, Nobuyuki Sakai, Yoshiaki Shiokawa, Norio Tanahashi, Masahiro Yasaka, Yasuo Katayama, Susumu Miyamoto, Akira Ogawa, Makoto Sasaki, Sadao Suga, Taken Tags: Original Articles Source Type: research