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Condition: Thrombosis

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Alpha 1-Antitrypsin Therapy Mitigated Ischemic Stroke Damage in Rats
Our objective is to develop a new therapy for the treatment of stroke. Currently, the only effective therapy for acute ischemic stroke is the thrombolytic agent recombinant tissue plasminogen activator. α1-Antitrypsin (AAT), a serine proteinase inhibitor with potent anti-inflammatory, anti-apoptotic, antimicrobial, and cytoprotective activities, could be beneficial in stroke. The goal of this study is to test whether AAT can improve ischemic stroke outcome in an established rat model. Middle cerebral artery occlusion was induced in male rats via intracranial (i.c.) microinjection of endothelin-1. Five to 10 minutes after...
Source: Journal of Stroke and Cerebrovascular Diseases - March 3, 2014 Category: Neurology Authors: Huong L. Moldthan, Aaron C. Hirko, Jeffrey S. Thinschmidt, Maria B. Grant, Zhimin Li, Joanna Peris, Yuanqing Lu, Ahmed S. Elshikha, Michael A. King, Jeffrey A. Hughes, Sihong Song Tags: Original Articles Source Type: research

Strategic Planning to Reduce the Burden of Stroke Among Veterans: Using Simulation Modeling to Inform Decision Making Clinical Sciences
Conclusions— Prevention strategies tend to have larger population impacts, though interventions targeting specific high-risk groups tend to be more efficient in terms of number-needed-to-treat per QALY gained.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Lich, K. H., Tian, Y., Beadles, C. A., Williams, L. S., Bravata, D. M., Cheng, E. M., Bosworth, H. B., Homer, J. B., Matchar, D. B. Tags: Health policy and outcome research Clinical Sciences Source Type: research

Von Willebrand Factor Drives the Association Between Elevated Factor VIII and Poor Outcomes in Patients With Ischemic Stroke Brief Reports
Conclusions— Concurrent FVIII/vWF elevation predicts higher odds of inpatient complications, neuroworsening, and worse functional outcomes for patients with AIS compared with patients with normal levels. Our findings suggest that FVIII and vWF levels may serve as clinically useful stroke biomarkers by providing risk profiles for patients with AIS.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Samai, A., Monlezun, D., Shaban, A., George, A., Dowell, L., Kruse-Jarres, R., Schluter, L., El Khoury, R., Martin-Schild, S. Tags: Coagulation, Thrombophilia, Acute Cerebral Infarction Brief Reports Source Type: research

Transcranial Laser Therapy in Acute Stroke Treatment: Results of Neurothera Effectiveness and Safety Trial 3, a Phase III Clinical End Point Device Trial Major Clinical Trial
Conclusions— Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. Clinical Trial Registration— URL: http...
Source: Stroke - October 27, 2014 Category: Neurology Authors: Hacke, W., Schellinger, P. D., Albers, G. W., Bornstein, N. M., Dahlof, B. L., Fulton, R., Kasner, S. E., Shuaib, A., Richieri, S. P., Dilly, S. G., Zivin, J., Lees, K. R., for the NEST 3 Committees and Investigators, Broderick, Ivanova, Johnston, Norrvin Tags: Acute Cerebral Infarction Major Clinical Trial Source Type: research

Sensitivity and Specificity of the Hyperdense Artery Sign for Arterial Obstruction in Acute Ischemic Stroke Clinical Sciences
Conclusions— When present in acute ischemic stroke, HAS indicates a high likelihood of arterial obstruction, but its absence indicates only a 50/50 chance of normal arterial patency. Thin-slice CT improves sensitivity of HAS detection. Clinical Trial Registration— URL: http://www.controlled-trials.com/ISRCTN25765518. Unique identifier: ISRCTN25765518.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Mair, G., Boyd, E. V., Chappell, F. M., von Kummer, R., Lindley, R. I., Sandercock, P., Wardlaw, J. M., IST-3 Collaborative Group Tags: Arterial thrombosis, Acute Cerebral Infarction, Angiography Clinical Sciences Source Type: research

Distance to Thrombus in Acute Middle Cerebral Artery Occlusion: A Predictor of Outcome After Intravenous Thrombolysis for Acute Ischemic Stroke Clinical Sciences
Conclusion— DT is an independent predictor of clinical outcome in patients with acute MCA occlusion treated with IVT. In acute stroke with MCA occlusion confirmed by CT angiography and DT <16 mm, the likelihood of a good clinical outcome after treatment with IVT was exponentially <50%. This might warrant the evaluation of other therapy forms than IVT in patients with proximal MCA occlusion.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Friedrich, B., Gawlitza, M., Schob, S., Hobohm, C., Raviolo, M., Hoffmann, K.-T., Lobsien, D. Tags: Thrombolysis Clinical Sciences 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

Combined lysis of thrombus with ultrasound and systemic tissue plasminogen activator for emergent revascularization in acute ischemic stroke (CLOTBUST‐ER): design and methodology of a multinational phase 3 trial
ConclusionsSince intravenous recombinant tissue‐plasminogen‐activator remains the only medical therapy to reverse ischemic stroke applicable in the emergency department, our trial will determine if the additional use of transcranial ultrasound improves functional outcomes in patients with severe acute ischemic stroke (NCT#01098981).
Source: International Journal of Stroke - June 29, 2015 Category: Neurology Authors: Peter D. Schellinger, Andrei V. Alexandrov, Andrew D. Barreto, Andrew M. Demchuk, Georgios Tsivgoulis, Martin Kohrmann, John Alleman, Virginia Howard, George Howard, Anne W. Alexandrov, Gordon Brandt, Carlos A. Molina, Tags: Protocol Source Type: research

Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program
The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program.
Source: Journal of Stroke and Cerebrovascular Diseases - April 6, 2016 Category: Neurology Authors: Dae-Hyun Kim, Hyun-Wook Nah, Hyun-Seok Park, Jae-Hyung Choi, Myong-Jin Kang, Jae-Taeck Huh, Jae-Kwan Cha Source Type: research

Rivaroxaban Versus Dabigatran or Warfarin in Real-World Studies of Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—In this systematic review and meta-analysis, rivaroxaban was as effective as dabigatran, but was more effective than warfarin for the prevention of stroke/thromboembolism in atrial fibrillation patients. Major bleeding risk was significantly higher with rivaroxaban than with dabigatran, as was all-cause mortality and gastrointestinal bleeding. Rivaroxaban was comparable to warfarin for major bleeding, with an increased risk in gastrointestinal bleeding and decreased risk of intracranial hemorrhage.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Ying Bai, Hai Deng, Alena Shantsila, Gregory Y.H. Lip Tags: Meta Analysis, Quality and Outcomes Original Contributions Source Type: research

Pulmonary embolism in acute ischaemic stroke (p4.293)
Conclusions:PE was observed in 0.32% of AIS and associated with high rates of death and disability. CTA stroke protocol images from aortic arch to vertex allows visualization of upper pulmonary arteries and detection PE in AIS.Disclosure: Dr. Eswaradass has nothing to disclose. Dr. Dey has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Hill has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Eswaradass, P. V., Dey, S., Singh, D., Hill, M. Tags: In-Hospital Stroke Care Source Type: research

Annexin A2 Plus Low-Dose Tissue Plasminogen Activator Combination Attenuates Cerebrovascular Dysfunction After Focal Embolic Stroke of Rats
The objective of this study was to investigate the effects and mechanisms of the combination in early BBB integrity and cerebrovascular patency in the rat focal embolic stroke model. Ischemic brain infarct volume and hemorrhagic transformation were quantified at 24  h after stroke. At an earlier time point, 16 h after stroke, BBB integrity was evaluated by IgG extravasation, and the involved mechanisms were assessed for tight junction ZO-1 and adhesion junction ve-cadherin protein expression, matrix metalloproteinase activation, extracellular matrix collagen IV and endothelial barrier antigen expression, and activation o...
Source: Translational Stroke Research - June 3, 2017 Category: Neurology Source Type: research

Campaign —Once Again Streptokinase Trials (COAST) in Acute Ischemic Stroke
Every year, 1.5 million people suffer from stroke worldwide, the leading cause of disability and the second most common cause of death.1 Stroke incidence in developing countries is much higher and is further rising,2 whereas access to effective acute stroke treatment is very limited. Only 1% stroke sufferers in developing countries have access to the highly expensive tissue plasminogen activator (tPA), the only proven and recommended thrombolytic agent for acute ischemic stroke treatment.3
Source: Journal of Stroke and Cerebrovascular Diseases - December 18, 2017 Category: Neurology Authors: Muhammad Shabbir, Arsalan Ahmad Tags: Letter to the Editor Source Type: research

Treatment and outcome of childhood cerebral sinovenous thrombosis
Conclusions Within the IPSS registry, children with risk factors of trauma or intracranial surgery were less likely to receive anticoagulation for CSVT. Anticoagulation was associated with a lower odds of severe neurologic impairment or death at hospital discharge, but this finding is limited and needs further confirmation in randomized, controlled, prospective studies.
Source: Neurology Clinical Practice - June 7, 2020 Category: Neurology Authors: Felling, R. J., Hassanein, S. M. A., Armstrong, J., Aversa, L., Billinghurst, L., Goldenberg, N. A., Lee, J. E., Maxwell, E. C., Noetzel, M. J., Lo, W., on behalf of the International Pediatric Stroke Study Group Tags: Childhood stroke, Hematologic, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Intracerebral hemorrhage, Cerebral venous thrombosis Research Source Type: research