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Specialty: Neurology
Education: Study
Therapy: Thrombolytic Therapy

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Total 309 results found since Jan 2013.

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

Beating the Clock: Time Delays to Thrombolytic Therapy with Advanced Imaging and Impact of Optimized Workflow
This study is to assess the time delay while using this scanner compared with our 64-slice scanner.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2015 Category: Neurology Authors: Santanu Chakraborty, James Ross, Mathew J. Hogan, Dar Dowlatshahi, Grant Stotts Source Type: research

An Executable Graphical Model for In Silico Prototyping of Processes for Acute Stroke Care (P1.019)
CONCLUSIONS: In silico care process prototyping permits evaluation of proposed innovations in simulated settings. 1. Grotta JC. tPA for stroke: important progress in achieving faster treatment. JAMA. 2014 Apr 23-30;311(16):1615-7. 2. Ford AL et al. Reducing door-to-needle times using Toyota's lean manufacturing principles and value stream analysis. Stroke. 2012 Dec;43(12):3395-8. 3. Meretoja A et al. Reducing in-hospital delay to 20 minutes in stroke thrombolysis. Neurology. 2012 Jul 24;79(4):306-13. Study Supported by:Genentech, Inc.Disclosure: Dr. Norris has received personal compensation for activities with Genentech. D...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Norris, D., Levy, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Patient Factors Do Not Predict Thrombolysis in Stroke Mimics (P6.031)
CONCLUSIONS: Physician decision to administer thrombolysis in stroke mimic patients without clear contraindication is not associated with patient demographic or clinical factors. Our study is limited by its retrospective nature and small sample size, however continued data collection is in process.Disclosure: Dr. Gildersleeve has nothing to disclose. Dr. Pandurengan has nothing to disclose. Dr. Gonzales has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Gildersleeve, K., Pandurengan, R., Gonzales, N. Tags: Neurotherapeutics Source Type: research

Embolic stroke with spontaneous recanalization (P3.085)
Conclusions This study infers that thrombolysis remarkably improves clinical outcome in patients with embolic stroke who do not have visible arterial occlusion at presentation. A prospective study to validate these results is being planned.Disclosure: Dr. Lahoti has nothing to disclose. Dr. Gokhale has nothing to disclose. Dr. Caplan has received personal compensation in an editorial capacity for JAMA Neurology. Dr. Michel has received personal compensation for activities with Servier, Sanofi-Aventis Pharmaceuticals, and Boehringer Ingelheim Pharmaceuticals, as a speaker, steering committee member, and/or advisory board me...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D., Pettigrew, L. Tags: Cerebrovascular Disease and Interventional Neurology: Hemorrhagic and Ischemic Stroke Source Type: research

Burden of stroke in Italy: An economic model highlights savings arising from reduced disability following thrombolysis
ConclusionOur study reveals that performing thrombolytic therapy in eligible patients improves economic outcomes compared with patients receiving standard care. This model is useful for decision makers, both within and outside of the Italian national context, as a tool to assess the cost‐effectiveness of thrombolysis in both short‐ and long‐term period.
Source: International Journal of Stroke - April 8, 2015 Category: Neurology Authors: M. Chiumente, M. M. Gianino, D. Minniti, T. J. Mattei, B. Spass, K. M. Kamal, D. E. Zimmerman, A. Muca, E. Luda Tags: Research Source Type: research

A Novel Method for Measuring Oxidative Stress in Patients with Stroke Symptoms (S52.005)
CONCLUSIONS: These results demonstrate the ability of ORP to identify oxidative stress and amount of antioxidant reserves in a stroke population. We propose ORP monitoring as a potentially useful tool in evaluation of acute stroke patients.Disclosure: Dr. Wagner has received personal compensation for activities with Genentech, Inc. Dr. Salottolo has nothing to disclose. Dr. Fanale has received personal compensation for activities with Genentech, Inc. as a speaker. Dr. Whaley has nothing to disclose. Dr. McCarthy has nothing to disclose. Luoxis Diagnostics, Inc,
Source: Neurology - April 8, 2015 Category: Neurology Authors: Wagner, J., Salottolo, K., Fanale, C., Whaley, M., McCarthy, K., BarOr, D. Tags: General Neurology: Neural Networks and Neuromodulation Source Type: research

Improvement in Rates of Thrombolytic Therapy in Acute Stroke by a Telestroke Program in Rural Northern Wisconsin (P1.011)
Conclusion: Following development of a Telestroke program in northern Wisconsin, rural stroke patients benefited from dramatic increases in access to neurological expertise and acute thrombolytic treatment. Patients and providers have embraced the program with plans to expand Telestroke to other remote access hospitals.Disclosure: Dr. Kartje has nothing to disclose. Dr. Klemm has nothing to disclose. Dr. Heil has nothing to disclose. Dr. Antoniotti has nothing to disclose. Dr. Martin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kartje, R., Klemm, S., Heil, L., Antoniotti, N., Martin, T. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Systems and Care Process Parameters as Determinants of Onset-to-Treatment Times in Acute Ischemic Stroke: A Simulation Study (P1.018)
CONCLUSIONS: We employed a realistic simulation of AIS care to explore performance characteristics of proposed AIS care process configurations during the narrow window of opportunity to deliver thrombolytic therapy. This simulation methodology provides a model for prototyping process reengineering, in which essential details and assumptions in AIS care are identified for critical review by stakeholders. Study Supported by: Genentech, Inc.Disclosure: Dr. Levy has received personal compensation for activities with Genentech. Dr. Norris has received personal compensation for activities with Genentech. Dr. Tayama has received ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Levy, D., Norris, D., Tayama, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

Stroke Care Within the Golden Hour
To the Editor In a study published in JAMA Neurology, Ebinger et al assessed the efficacy of prehospital thrombolytic therapy during the golden hour for acute ischemic stroke. The authors concluded that prehospital “thrombolysis entails no risk to the patients’ safety and is associated with better short-term outcomes.” However, limitations in the study’s methods create uncertainty in this assertion. The issue at hand is noted by the authors in the following statement, “Patients with stroke mimics who received [tissue plasminogen activator] were not included in this evaluation of treatment effects.” Thus, the da...
Source: JAMA Neurology - April 1, 2015 Category: Neurology Source Type: research

Validity of Shape as a Predictive Biomarker of Final Infarct Volume in Acute Ischemic Stroke Clinical Sciences
Conclusions— Our findings suggest that lesion shape contains important predictive information and reflects important environmental factors that might determine the progression of ischemia from the core.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Frindel, C., Rouanet, A., Giacalone, M., Cho, T.-H., Ostergaard, L., Fiehler, J., Pedraza, S., Baron, J.-C., Wiart, M., Berthezene, Y., Nighoghossian, N., Rousseau, D. Tags: Acute Cerebral Infarction, Brain Circulation and Metabolism Clinical Sciences Source Type: research

Balancing access and quality in comprehensive stroke care
The establishment of stroke units and stroke centers has transformed the inpatient care of cerebrovascular disease and resulted in improved outcomes for patients hospitalized with stroke. Studies show that organized care as part of a stroke unit results in reduced mortality and disability after stroke,1 and that patients hospitalized at primary stroke centers have lower mortality and are more likely to receive thrombolytic therapy.2
Source: Neurology - March 23, 2015 Category: Neurology Authors: Kelly, A. G., Attia, J. Tags: All Health Services Research, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, All epidemiology EDITORIALS Source Type: research

Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis
Conclusions Three scores showed good agreement with sICH: DRAGON, Stroke-TPI, and HAT with odds ratios substantially greater than 1. Stroke-TPI and HAT additionally benefited from low computational complexity and therefore performed best overall. Our results demonstrate the utility of clinical scores as predictors of sICH in acute ischemic stroke patients undergoing IV thrombolytic therapy.
Source: Neurocritical Care - March 18, 2015 Category: Neurology Source Type: research

Drip and Ship Thrombolytic Therapy for Acute Ischemic Stroke: Use, Temporal Trends, and Outcomes Clinical Sciences
Conclusions— Drip and ship tPA is common, used in 1 in 4 patients treated with tPA in the United States. Modest differences in mortality and symptomatic intracranial hemorrhage may be because of patient selection bias, post-tPA care differences, or unmeasured confounding. The drip and ship paradigm may facilitate widespread tPA use in patients with acute stroke.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Sheth, K. N., Smith, E. E., Grau-Sepulveda, M. V., Kleindorfer, D., Fonarow, G. C., Schwamm, L. H. Tags: Acute Cerebral Infarction, Acute Stroke Syndromes, Embolic stroke, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Platelet rich clots are resistant to lysis by thrombolytic therapy in a rat model of embolic stroke
Conclusions Site specific delivery of platelet rich clots to the MCA origin resulted in high rates of MCA occlusion, low rates of spontaneous clot lysis and large infarction. These platelet rich clots were highly resistant to tPA with or without microbubble-enhanced sonothrombolysis. This resistance of platelet rich clots to enhanced thrombolysis may explain recanalization failures clinically and should be an impetus to better clot-type identification and alternative recanalization methods.
Source: Experimental and Translational Stroke Medicine - January 27, 2015 Category: Neurology Source Type: research