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Identifying Gaps and Missed Opportunities for Intravenous Thrombolytic Treatment of Inpatient Stroke
Conclusion: In our study, one in three ISC were true strokes. IVT treatment rates were low with a MTO of 1 in 6 IVT-eligible patients. The most common reason for not treating was NIHSS ≤4. Knowing predictors of true stroke and the common barriers to IVT treatment can help narrow this treatment gap.
Source: Frontiers in Neurology - February 26, 2020 Category: Neurology Source Type: research
Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up?
Alteplase is the only Food and Drug Administration-approved intravenous (IV) thrombolytic medication for acute ischemic stroke. However, multiple recent studies comparing tenecteplase and alteplase suggest that tenecteplase is at least as efficacious as alteplase with regards to neurologic improvement. When given at 0.25 milligrams per kilogram (mg/kg), tenecteplase may have less bleeding complications than alteplase as well. This narrative review evaluates the literature and addresses the practical issues with regards to the use of tenecteplase versus alteplase for acute ischemic stroke, and it recommends that physicians ...
Source: Western Journal of Emergency Medicine - February 24, 2020 Category: Emergency Medicine Source Type: research
Stroke following successful PTMC in a patient with severe mitral stenosis: A case report and presenting a simple stepwise approach to PTMC-related stroke.
We present a middle-aged woman who experienced stroke following PTMC and successfully treated with thrombolytic therapy regarding the potential adverse effects of this type of therapy. Also, we present a simple novel stepwise clinical approach for PTMC-related stroke. PMID: 32077834 [PubMed - as supplied by publisher]
Source: Cardiovascular and Hematological Disorders Drug Targets - February 22, 2020 Category: Drugs & Pharmacology Tags: Cardiovasc Hematol Disord Drug Targets Source Type: research
RapaLink-1 plays an antithrombotic role in antiphospholipid syndrome by improving autophagy both in vivo and vitro.
CONCLUSION: Our results revealed that Rapalink-1 has a potential to inhibit the formation of thrombus plaque in APS and these effects were dependent on facilitating cell autophagy both in vivo and in vitro. PMID: 32093890 [PubMed - as supplied by publisher]
Source: Biochemical and Biophysical Research communications - February 22, 2020 Category: Biochemistry Authors: Mu F, Jiang Y, Ao F, Wu H, You Q, Chen Z Tags: Biochem Biophys Res Commun Source Type: research
Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit
ConclusionsrTPA in WUS patients selected with CT and/or CTP resulted in reduced ischemic infarct volume on follow-up CT and better functional outcome without increment of intracranial hemorrhages and in-hospital mortality.
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research
Response to: Management of prosthetic valve thrombosis complicated by ischemic stroke in pregnancy
Publication date: November 2019Source: Revista Portuguesa de Cardiologia (English Edition), Volume 38, Issue 11Author(s): Gonçalo J. Morgado, Inês R. Cruz, Ana Catarina Gomes, Ana Rita Almeida, Maria José Loureiro, Carlos Cotrim, Hélder Pereira
Source: Revista Portuguesa de Cardiologia - February 21, 2020 Category: Cardiology Source Type: research
Management of prosthetic valve thrombosis complicated by ischemic stroke in pregnancy
Publication date: November 2019Source: Revista Portuguesa de Cardiologia (English Edition), Volume 38, Issue 11Author(s): Ahmet Guner, Macit Kalçık, Emrah Bayam, Semih Kalkan, Mehmet Ozkan
Source: Revista Portuguesa de Cardiologia - February 21, 2020 Category: Cardiology Source Type: research
Novel antithrombotic effects of dabigatran in patients with non-valvular atrial fibrillation
Ischemic heart disease and stroke are major causes of death and morbidity worldwide. Coronary and cerebrovascular events are a consequence of thrombus formation caused by atherosclerotic plaque rupture or embolism, both of which result from platelet activation and aggregation and thrombin-mediated fibrin generation via the coagulation cascade . In addition, thrombin is also one of the most effective platelet activators . We focused on a novel thrombus formation mechanism called thrombin-mediated platelet stimulation and established thrombin-induced platelet aggregation .
Source: Thrombosis Research - February 21, 2020 Category: Hematology Authors: Keisuke Tsuda, Tatsunori Natori, Mie Shimizu, Yoko Ishigaku, Kiyotaka Oi, Shinsuke Narumi, Asami Kamada, Makiko Yoshida, Kazumasa Oura, Tetsuya Maeda, Yasuo Terayama Tags: Letter to the Editors-in-Chief Source Type: research
Details on the effect of very short dual antiplatelet therapy after drug-eluting stent implantation in patients with high bleeding risk: insight from the STOPDAPT-2 trial
In conclusion, the effects of 1-month DAPT for the primary and major secondary endpoints were consistent in HBR and non-HBR patients without any significant interactions. The benefit of 1-month DAPT in reducing major bleeding was numerically greater in HBR patients.Clinical trial registration Short and optimal duration of dual antiplatelet therapy after everolimus-eluting cobalt –chromium stent-2 [STOPDAPT-2]; NCT02619760.
Source: Cardiovascular Intervention and Therapeutics - February 21, 2020 Category: Cardiology Source Type: research
Value of thrombus imaging in predicting the outcomes of patients with large-vessel occlusive strokes after endovascular therapy
ConclusionImaging of thrombus can be used as an aseessment tool to predict the outcomes and it needs further studies in the future.
Source: Neurological Sciences - February 21, 2020 Category: Neurology Source Type: research
TNK Dose in Large-Vessel Stroke: 0.25 mg/kg Is Sufficient TNK Dose in Large-Vessel Stroke: 0.25 mg/kg Is Sufficient
New data from a second EXTEND-IA TNK (tenecteplase) trial clarify the optimum dose of the bolus thrombolytic for use in ischemic stroke, for which enthusiasm is growing.Medscape Medical News
Source: Medscape Cardiology Headlines - February 20, 2020 Category: Cardiology Tags: Neurology & Neurosurgery News Source Type: news
Association of Small Dense Low-Density Lipoprotein Cholesterol with Stroke Risk, Severity and Prognosis.
CONCLUSIONS: Elevated levels of sdLDL-C were associated with a higher prevalence of AIS, especially in non-cardioembolic stroke subtypes. After adjustment for other risk factors, sdLDL-C was found to be an independent risk factor for AIS. Also, sdLDL-C level was strongly associated with AIS severity and poor functional outcomes. Logistic regression models for AIS risk and prognosis prediction were established to help clinicians provide better prevention for high-risk subjects and monitor their prognosis. PMID: 32062644 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - February 20, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Mechanical Thrombectomy for Posterior Circulation Occlusion: A Comparison of Outcomes with the Anterior Circulation Occlusion - A Meta-Analysis.
CONCLUSIONS: We found that the outcomes of MT for patients with PCO were poorer than with ACO. On the other hand, MT appears to have lower rates of sICH and to increase successful recanalization. Given the high recanalization rate, MT may serve as an adjunct to standard treatment. The key point to improve outcomes is recognizing reliable factors associated with futile recanalization and optimizing the results of MT. But in view of the different characteristics of posterior circulation stroke and anterior circulation stroke, the results are far from robust. PMID: 32062629 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - February 20, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Impact of Patent Foramen Ovale on Total Knee Arthroplasty Cerebrovascular Accident Perioperative Management.
This study was undertaken to determine whether patients with a PFO would have a significantly increased risk of cerebrovascular accident (CVA) following TKA. The Humana national database was used to identify TKA patients who were stratified by the presence of a PFO from 2007 to 2016. Ninety-day follow-up was used for the primary outcome of CVA. Potential confounding comorbidities also were investigated, including age, sex, anticoagulation, insurance type, arrhythmia, valvular disease, peripheral vascular disease, chronic kidney disease, and diabetes mellitus. Of 153,245 TKAs, a total of 2272 patients had strokes; 479 of th...
Source: Orthopedics - February 20, 2020 Category: Orthopaedics Authors: Hong CS, Politzer C, Ryan SP, Wellman SS, Jiranek WA, Bolognesi MP, Seyler TM Tags: Orthopedics Source Type: research
Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture
We report on a patient with acute ischemic stroke secondary to carotid plaque rupture who experienced plaque thrombosis and marked clinical worsening despite IVT. While the latter is the gold standard therapy optimal platelets inhibition should be guaranteed to allow a safe as possible carotid intervention. Hereby we discuss all available strategies to be considered in order to better individualized treatment decision-making.
Source: Journal of Thrombosis and Thrombolysis - February 20, 2020 Category: Hematology Source Type: research
Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents
Semin Neurol DOI: 10.1055/s-0040-1702942Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical–radiologic diagnosis that affects children and adolescents, but it is much more frequently reported in adults. Clinically, patients present with severe and commonly recurrent thunderclap headaches. Typical precipitating triggers include vasoactive substances, serotonergic agents, and the postpartum period. There may be associated neurologic complications at presentation or in the weeks following, such as convexity subarachnoid hemorrhage, stroke, cerebral edema, cervical artery dissection (CeAD), and seizures. Angio...
Source: Seminars in Neurology - February 20, 2020 Category: Neurology Authors: Qubty, William Irwin, Samantha Lee Fox, Christine K. Tags: Review Article Source Type: research
Subclinical valve thrombosis in transcatheter aortic valve implantation: A systematic review and meta-analysis.
Recent high-resolution CT studies after transcatheter aortic valve insertion (TAVI) have reported high prevalence of subclinical valve thrombosis (SCVT), potentially contributing to increased risk of late stroke. We aimed to investigate SCVT after TAVI patients with focus on prevalence, predisposing factors, management, and potential sequelae.
Source: The Journal of Thoracic and Cardiovascular Surgery - February 19, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Kei Woldendorp, Mathew P. Doyle, Deborah Black, Martin Ng, Anthony Keech, Stuart Grieve, Paul G. Bannon Source Type: research
Computed Tomography Perfusion Showing Cerebral Hypoperfusion in a Patient with Acute Cerebral Venous Sinus Thrombosis —A Case Report
We report the case of a patient with acute CVST, showing perfusion abnormalities on computed tomography perfusion with perfusion defect in the relevant hemisphere. The defect was found in a region adjacent to the occluded sinus and was not corresponding to an arterial territory. To the best of our knowledge this is the first ever report on CT perfusion abnormalities few hours after acute symptom onset in CVST.
Source: Journal of Stroke and Cerebrovascular Diseases - February 18, 2020 Category: Neurology Authors: Robbert-Jan van Hooff, Jesper Gyllenborg, Kayal Jesuratnam-Nielsen, Troels Wienecke Tags: Case Report Source Type: research
A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - February 18, 2020 Category: Neurology Source Type: research
Utility of Transthoracic Echocardiography in Diagnostic Evaluation of Ischemic Stroke
Conclusion: Our findings suggest that despite widespread use, the overall yield of TTE in AIS is low. Stratifying patients according to their likelihood of benefitting from it will be important toward better resource utilization.
Source: Frontiers in Neurology - February 18, 2020 Category: Neurology Source Type: research
Anticoagulation for atrial fibrillation patients with the CHA2DS2-VASc score =1 (beyond sex).
Authors: Xie X, Li T Abstract Objective: We investigated the risk of ischaemic stroke in patients with 1 another stroke risk factor (i.e. CHA2DS2-VASc score =1 [males] or 2 [females]) and the impact of different component risk factors.Methods: Database were collected from two hospitals in the city of Hohhot in china. Among 3148 Nonvalvular AF patients not on antiplatelet or anticoagulant therapy, we evaluated males with a CHA2DS2-VASc score of 1 and females with a CHA2DS2-VASc score of 2. The clinical endpoint was the occurrence of ischaemic stroke.Results: Among 546 AF male patients with a CHA2DS2-VASc score of ...
Source: Acta Cardiologica - February 16, 2020 Category: Cardiology Tags: Acta Cardiol Source Type: research
Impact of thrombus migration on clinical outcomes in patients with internal carotid artery occlusions and patent middle cerebral artery
Patency of the middle cerebral artery (MCA) in acute ischemic stroke with internal carotid artery (ICA) occlusions is associated with less severe stroke and favorable outcomes. However, thrombus migration to distal intracranial vessels may lead to unfavorable outcomes. We investigated the influence of thrombus migration on clinical outcomes in patients with ICA occlusions and patent MCA.
Source: Journal of the Neurological Sciences - February 15, 2020 Category: Neurology Authors: Junpei Koge, Shoji Matsumoto, Ichiro Nakahara, Akira Ishii, Taketo Hatano, Yujiro Tanaka, Daisuke Kondo, Jun-ichi Kira, Izumi Nagata Source Type: research
Characteristic and prognosis of acute large vessel occlusion in anterior and posterior circulation after endovascular treatment: the ANGEL registry real world experience
AbstractThere were limited studies comparing the anterior (AC) and posterior (PC) circulation acute ischemic strokes (AIS). Our study aimed to evaluate distinct features of AC and PC strokes regarding clinical, vascular risk, pathogenesis and outcome factors after endovascular procedures. This multicenter prospective study registered 873 patients with acute large occlusion of anterior circulation stroke (ACS) and posterior circulation stroke (PCS). Patients who underwent endovascular procedures were included in this study. The differences in ACS and PCS regarding baseline characteristics, post-operative intracranial hemorr...
Source: Journal of Thrombosis and Thrombolysis - February 14, 2020 Category: Hematology Source Type: research
Targeting Inflammation and Immune System in Acute Myocardial Infarction.
Authors: Alwi I Abstract Over more than two decades, the concept of atherosclerosis has developed and lead to inflammatory hypothesis. Inflammation plays an important role on pathogenesis of atherothrombosis and coronary heart disease (CHD), including acute coronary syndrome (ACS). Although the management of ACS has been demonstrated to be beneficial for secondary prevention of coronary heart disease (such as using statin and aspirin) and also seemed to have positive effect on inflammation, the identification of effective management, specifically targeting inflammation, has been not been comprehensively understood....
Source: Acta medica Indonesiana - February 13, 2020 Category: Internal Medicine Tags: Acta Med Indones Source Type: research
Blood-brain barrier integrity of stroke patients presenting in an extended time window
Current guidelines limit thrombolytic treatment of stroke to those patients who present within 4.5 h to minimize the risk of hemorrhagic complications. Risk of hemorrhage increases with increasing blood-brain ...
Source: BMC Neurology - February 13, 2020 Category: Neurology Authors: Jarrhett Butler, Parisa Heidari, Sarah Blayney, Emi Hitomi, Marie Luby and Richard Leigh Tags: Research article Source Type: research
Atrial myxoma with cerebellar signs: a case report
ConclusionAlthough rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.
Source: Journal of Medical Case Reports - February 13, 2020 Category: General Medicine Source Type: research
Predicting the Risk of Ischemic Stroke among Patients with Rheumatoid Arthritis Using a Simplified RA-CHADSV Score Based on the CHA2DS2-VASc Score.
CONCLUSIONS: A simplified RA-CHADSV score, with comparable efficiency as the CHA2DS2-VASc score, but easier to use clinically was developed for predicting the risk of ischemic stroke among non-AF RA patients. PMID: 32059458 [PubMed - in process]
Source: Medicina (Kaunas) - February 12, 2020 Category: Universities & Medical Training Authors: Hsu CW, Ng KJ, Lu MC, Koo M Tags: Medicina (Kaunas) Source Type: research
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
This study is registered at ClinicalTrials.gov (NCT02027896).FindingsBetween March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p<0·0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0·91 (95% CI 0·72 to 1·14) and absolute ris...
Source: The Lancet - February 11, 2020 Category: General Medicine Source Type: research
A Rare Case Report Of Dabigatran Induced Oral Ulcers.
CONCLUSION: Patient education and counselling should be done regarding this side effect of dabigatran and proper intake of this medicine. PMID: 32048978 [PubMed - as supplied by publisher]
Source: Current Drug Safety - February 11, 2020 Category: Drugs & Pharmacology Authors: Singh A, Prabha N, Yadav H Tags: Curr Drug Saf Source Type: research
Left Atrial Appendage Closure in Patients With Intracranial Hemorrhage and Nonvalvular Atrial Fibrillation
Background: Left atrial appendage (LAA) closure is primarily performed in patients who have contraindications to anticoagulants. However, anticoagulants are recommended for the first few weeks after LAA closure to prevent the device related thrombus. Purpose of this study was to evaluate if short term use of anticoagulant is safe and effective after LAA closure in patients with a history of intracranial hemorrhage. Methods: It is a retrospective observational study done at a single center. Baseline characteristics, perioperative, and postoperative complications of patients with a history of intracranial hemorrhage and Watc...
Source: Journal of Stroke and Cerebrovascular Diseases - February 11, 2020 Category: Neurology Authors: Muhammad Ajmal, Hursh Naik, Abraham Kocheril Source Type: research
Cerebral Venous Thrombosis in Hematological Malignancy: Balancing the Risks
Background and Aim: The coexistence of cerebral venous thrombosis (CVT) and hematological neoplasms is rare. Currently available therapeutic options raise problems concerning the balance of thrombotic and hemorrhagic risks. Our purpose is to characterize a series of cases of CVT and concomitant hematological malignancy, focusing on predisposing factors and treatment strategies. Methods: We performed a descriptive retrospective analysis of the cases of CVT and hematological neoplasms diagnosed in a tertiary center from 2006 to 2015.
Source: Journal of Stroke and Cerebrovascular Diseases - February 11, 2020 Category: Neurology Authors: Maria Jo ão Pinto, Pedro Bettencourt Medeiros, Fernando Príncipe, Marta Carvalho Source Type: research
Clinical features and efficacy of reperfusion therapy in minor ischemic stroke patients with atrial fibrillation
AbstractThe efficacy of reperfusion therapy (RT) using intravenous infusion of recombinant tissue plasminogen activator and/or endovascular therapy for minor ischemic stroke (MIS) has not yet been established. The present study aimed to elucidate the clinical features of MIS patients with atrial fibrillation (AF) and examine whether they could be potential candidates for RT. Data of MIS patients, defined as those with a score ≤ 5 on the National Institute of Health Stroke Scale, were extracted from patients admitted to our hospital between 2006 and 2018, and clinical characteristics were compared between the AF and ...
Source: Journal of Thrombosis and Thrombolysis - February 11, 2020 Category: Hematology Source Type: research
Increased platelet activation in sleep apnea subjects with intermittent hypoxemia
ConclusionsIncreased platelet activation was present in otherwise healthy subjects with intermittent nocturnal hypoxemia due to underlying OSA. This prothrombotic milieu in the vasculature is likely a key contributing factor toward development of thrombosis and cardiovascular disease.Trial registrationNCT00859950
Source: Sleep and Breathing - February 8, 2020 Category: Respiratory Medicine Source Type: research
Increased platelet activation in sleep apnea subjects with intermittent hypoxemia.
CONCLUSIONS: Increased platelet activation was present in otherwise healthy subjects with intermittent nocturnal hypoxemia due to underlying OSA. This prothrombotic milieu in the vasculature is likely a key contributing factor toward development of thrombosis and cardiovascular disease. TRIAL REGISTRATION: NCT00859950. PMID: 32036486 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - February 8, 2020 Category: Sleep Medicine Authors: Krieger AC, Anand R, Hernandez-Rosa E, Maidman A, Milrad S, DeGrazia MQ, Choi AJ, Oromendia C, Marcus AJ, Drosopoulos JHF Tags: Sleep Breath Source Type: research
3-Month Outcome of Ischemic Stroke Patients Underwent Thrombolytic Therapy; a Cohort Study.
Conclusion: There was no significant correlation between 3-month disabilities of stroke patients underwent thrombolytic therapy and age, sex, time from initiation of symptoms, or vital signs on admission. Patients with a blood sugar lower than 144 had better 3-month outcome. PMID: 32021987 [PubMed]
Source: Accident and Emergency Nursing - February 7, 2020 Category: Emergency Medicine Authors: Sari Aslani P, Rezaeian S, Safari E Tags: Arch Acad Emerg Med Source Type: research
Development of a Cardiovascular Disease Risk Prediction Model Using the Suita Study, a Population-Based Prospective Cohort Study in Japan.
CONCLUSIONS: The Suita CVD risk model is feasible to use and improves predictability of the incidence of CVD relative to the FRS model in Japan. PMID: 32023562 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - February 7, 2020 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
A Pictorial Review of Intracranial Haemorrhage Revisited.
CONCLUSION: Unenhanced CT is a mainstay of acute phase imaging due to its availability and, sensitivity and specificity for detecting acute haemorrhage. Several imaging features can be identified on CT and, along with clinical information, can provide some certainty in diagnosis. For those suitable and where diagnostic uncertainty remains CT angiogram, time-resolved CT angiography and catheter angiography can help identify underlying AVMs, aneurysms, cavernomas and vasculitides. MRI is more sensitive for the detection of subacute and chronic haemorrhage and identification of underlying mass lesions. PMID: 32008532 [PubMed - in process]
Source: Current Medical Imaging Reviews - February 6, 2020 Category: Radiology Tags: Curr Med Imaging Rev Source Type: research
HVAD Cannula Position and Hemocompatibility-related Adverse Events
ConclusionsHVAD cannula coronal angle was associated with reduced right ventricular function and HRAE. Prospective studies evaluating surgical techniques to ensure optimal device positioning and its effects on HRAEs are warranted.
Source: The Annals of Thoracic Surgery - February 6, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research
Challenges in Drug Development Targeting Anti-atherosclerotic Proteins.
Abstract Atherosclerosis is a vascular disease responsible for acute heart attacks and stroke, which are leading causes of death not only in industrialized countries but also worldwide, and the number of patients afflicted by this disease has been increasing in Japan. High-density lipoprotein (HDL) is the plasma lipoprotein that carries what is often called your "good cholesterol" through the blood. This good cholesterol moniker is associated with HDL because higher circulating levels of this lipoprotein are associated with a well-known reduction in the risk of arteriosclerosis. Moreover, many protective mechanism...
Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan - February 6, 2020 Category: Drugs & Pharmacology Authors: Okuhira K Tags: Yakugaku Zasshi Source Type: research
Endovascular Thrombectomy of Calcified Emboli in Acute Ischemic Stroke: A Multicenter Study.
CONCLUSIONS: Acute ischemic stroke with large-vessel occlusion due to calcified emboli is a rare entity in patients undergoing thrombectomy, with considerably worse angiographic outcome and a higher mortality compared with patients with noncalcified thrombi. Good functional recovery at 3 months can still be achieved in about a quarter of patients. PMID: 32029470 [PubMed - as supplied by publisher]
Source: Nuklearmedizin - February 6, 2020 Category: Radiology Authors: Maurer CJ, Dobrocky T, Joachimski F, Neuberger U, Demerath T, Brehm A, Cianfoni A, Gory B, Berlis A, Gralla J, Möhlenbruch MA, Blackham KA, Psychogios MN, Zickler P, Fischer S Tags: AJNR Am J Neuroradiol Source Type: research
Reasons for discontinuation of novel oral anticoagulant therapy in patients with atrial fibrillation.
Conclusion: DOAC discontinuation rates varied significantly and appeared related to drug-specific side effects, patient-initiated discontinuation, and bleeding. We observed longer-term administration of apixaban, suggesting that this drug is better tolerated than dabigatran or rivaroxaban. PMID: 32011180 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - February 5, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research
HVAD Cannula Position and Hemocompatibility-related Adverse Events.
CONCLUSIONS: HVAD cannula coronal angle was associated with reduced right ventricular function and HRAE. Prospective studies evaluating surgical techniques to ensure optimal device positioning and its effects on HRAEs are warranted. PMID: 32035046 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - February 5, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Imamura T, Narang N, Nitta D, Fujino T, Nguyen A, Chung B, Holzhauser L, Kim G, Raikhelkar J, Kalantari S, Smith B, Juricek C, Rodgers D, Ota T, Song T, Jeevanandam V, Sayer G, Uriel N Tags: Ann Thorac Surg Source Type: research
rt-PA in Ischemic Stroke After Idarucizumab Administration rt-PA in Ischemic Stroke After Idarucizumab Administration
This case demonstrates that thrombolytic therapy with rt-PA after reversal of dabigatran with idarucizumab may be safe and feasible in patients with acute ischemic stroke with lacunar infarct.Journal of Medical Case Reports
Source: Medscape Today Headlines - February 4, 2020 Category: Consumer Health News Tags: Family Medicine/Primary Care Journal Article Source Type: news
Hjerneslag i Norge 2015 –16 – behandling og resultater.
Hjerneslag i Norge 2015–16 – behandling og resultater. Tidsskr Nor Laegeforen. 2020 Feb 04;140(2): Authors: Varmdal T, Indredavik B, Phan A, Fjærtoft H Abstract BACKGROUND: Treatment of stroke in Norway is decentralised; patients with stroke are treated at 50 different hospitals. We have surveyed the treatment of stroke in these hospitals and collated this with data from the Norwegian Stroke Registry. We wished to investigate whether there was any variation in treatment interventions and treatment outcomes between university hospitals and local hospitals. MATERIAL AND METHOD: A questionnaire...
Source: Tidsskrift for den Norske Laegeforening - February 4, 2020 Category: General Medicine Authors: Varmdal T, Indredavik B, Phan A, Fjærtoft H Tags: Tidsskr Nor Laegeforen Source Type: research
The Tasmanian Atrial Fibrillation Study (TAFS): Differences in Stroke Prevention According to Sex.
Conclusion and Relevance: Female patients with a high stroke risk were less likely to receive guideline-recommended treatment. This study provides new information on prescribing trends within the Australian setting and highlights the opportunity to improve the management of female patients with AF and 1 or more additional stroke risk factors. PMID: 32019321 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - February 4, 2020 Category: Drugs & Pharmacology Authors: Pilcher SM, Alamneh EA, Chalmers L, Bereznicki LR Tags: Ann Pharmacother Source Type: research
Outcomes of thrombolytic therapy in acute ischemic stroke: mothership, drip-and-ship, and ship-and-drip paradigms
Chulalongkorn Stroke Center is a comprehensive stroke center (CSC) located in Bangkok, Thailand. Our stroke network consists of different levels of spoke hospitals, ranging from community hospitals where throm...
Source: BMC Neurology - February 3, 2020 Category: Neurology Authors: Naruchorn Kijpaisalratana, Aurauma Chutinet, Wasan Akarathanawat, Pakkawan Vongvasinkul and Nijasri C. Suwanwela Tags: Research article Source Type: research
Acute Ischemic Stroke.
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - February 1, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
MicroRNAs in Venous Thrombo-Embolism
Publication date: Available online 1 February 2020Source: Clinica Chimica ActaAuthor(s): Anju Angelina Hembrom, Swati Srivastava, Iti Garg, Bhuvnesh KumarAbstractBackgroundVenous Thrombo-embolism (VTE) is the major preventable cause of death and disability worldwide. It has the third highest incidence rate of hospital death after coronary artery disease (CAD) and stroke. With the establishment of Virchow’s triad stating the major factors responsible for VTE including stasis, hypercoagulability and endothelial dysfunction, the last decade reported number of studies regarding its diagnosis and prophylaxis. Till date the mo...
Source: Clinica Chimica Acta - February 1, 2020 Category: Laboratory Medicine Source Type: research
The Hospital Zambrano Hellion venous thromboembolism rapid response team (PREVENTION-team): Improving pulmonary embolism and deep venous thrombosis patient care.
Abstract Background: Fast-track worldwide reperfusion programs improve outcomes in ST-elevation myocardial infarction and stroke. Similar programs called Program Evaluation and Review Technique (PERT) focus on submassive and massive pulmonary embolism (PE) excluding deep venous thrombosis (DVT). Methods: PREVENTION-team (Hospital Zambrano Hellion Venous Thromboembolism [VTE] Rapid Response). Primary objective: Fast-track stratification, diagnostics, and treatment (60-90 min) to improve proximal DVT and submassive and massive PE patients care. Secondary objectives: Increase diagnosis rate of low-risk...
Source: Archivos de Cardiologia de Mexico - February 1, 2020 Category: Cardiology Authors: Toro-Mijares RD, Jerjes-Sánchez C, Rodríguez D, Panneflek J, Vázquez-Guajardo M, Fabiani MA, Quintanilla J, Manautou L, Peña-Almaguer E, Cadena A, Cassagne G, Torre-Amione G Tags: Arch Cardiol Mex Source Type: research
Atrial premature activity detected after an ischaemic stroke unveils atrial myopathy.
CONCLUSIONS: After an ischaemic stroke or a transient ischaemic attack, excessive APCs are associated with LA remodelling. Thus, LA dilatation and dysfunction reflect early LA myopathy, which might itself be responsible for cardioembolic stroke. PMID: 32007362 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - January 29, 2020 Category: Cardiology Authors: Py A, Schaaf M, Duhamel S, Si-Mohamed S, Daher J, Altman M, de Breyne B, Mechtouff L, Placide J, Chauveau S, Chevalier P, Nighoghossian N, Bergerot C, Thibault H Tags: Arch Cardiovasc Dis Source Type: research