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Reasons for exclusion from intravenous thrombolysis in stroke patients admitted to the Stroke Unit
AbstractIntravenous (IV) thrombolysis is the treatment in ischemic stroke, but only the minority of patients receive this medication. The primary objective of this study was to explore the reasons associated with the decision not to offer IV thrombolysis to stroke patients admitted to the Stroke Unit (SU). We conducted a retrospective analysis based on data collected from 876 consecutive stroke patients admitted to the SU  <12  h of symptoms onset, treated or not with IV thrombolysis at the discretion of the treating neurologist. Of the 876 patients, 449 were thrombolysed and 427 non-thrombolysed. Stroke onset >4....
Source: Journal of Thrombosis and Thrombolysis - August 5, 2016 Category: Hematology Source Type: research

Clopidogrel and aspirin after ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis of randomized clinical trials
Conclusions: Among patients who presented with ischemic stroke/TIA, short-course clopidog rel plus aspirin immediately following the index event appears to be more effective than and as safe as monotherapy for secondary stroke prevention.
Source: Journal of Thrombosis and Thrombolysis - December 3, 2018 Category: Hematology Source Type: research

Standard operating procedure for idarucizumab reversal of dabigatran anticoagulation in ischemic and hemorrhagic stroke
Conclusion: Reversal of dabigatran with idarucizumab in stroke patients appears easy to manage, safe and beneficial. The SOPs aim to reassure stroke physicians to include dabigatran reversal into their daily clinical routine when dealing with patients presenting with ischemic or hemorrhagic stroke under dabigatran therapy.
Source: Journal of Thrombosis and Thrombolysis - February 4, 2023 Category: Hematology Source Type: research

Stroke risk factors and outcomes among hospitalized women with atrial fibrillation
In conclusion, women hospitalized with AF have a higher risk of stroke at 90 days compared with men. Anticoagulation at hospital discharge was omitted in 40% of women with AF, but when prescribed, was associated with a reduction in mortality and major adverse events at 90 days, respectivel y.Graphic abstractWe analyzed 5000 hospitalized patients with atrial fibrillation (AF) (1888 women and 3112 men) in an observational cohort study completed at our tertiary care medical center to assess sex-related differences in cardiovascular risk factors, prescription of antithrombotic therapy, and 90-day outcomes. We observed a 50% ...
Source: Journal of Thrombosis and Thrombolysis - May 26, 2021 Category: Hematology Source Type: research

Feasibility of rapid measurement of Rivaroxaban plasma levels in patients with acute stroke
AbstractPlasma levels of Rivaroxaban (RivLev) might be useful to guide therapeutic decisions in patients with acute stroke under Rivaroxaban. A prerequisite for the potential clinical usefulness is their rapid availability in emergency situations. Single-center explorative analysis from the Novel-Oral-Anticoagulants-in-Stroke-Patients-registry (NOACISP, cinicaltrials.gov:NCT02353585). We included consecutive patients with acute ischemic or hemorrhagic stroke under Rivaroxaban (last intake<48  h) in which RivLev determined by an automated anti-factor Xa-based chromogenic assay (Hyphen-Biomed, France) are available. Prim...
Source: Journal of Thrombosis and Thrombolysis - December 31, 2016 Category: Hematology Source Type: research

Management of oral anticoagulation in very old patients with non valvular atrial fibrillation related acute ischemic stroke
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - October 16, 2019 Category: Hematology Source Type: research

Incidence and consequences of resuming oral anticoagulant therapy following hematuria and risks of ischemic stroke and major bleeding in patients with atrial fibrillation
In conclusion, more and more patients who suffer a hematuria while on oral anticoagulant therapy resume NOAC. Patients resuming NOAC have similar risks of ischemic stroke/systemic embolism and major bleeding compared with those resuming VKA.
Source: Journal of Thrombosis and Thrombolysis - May 13, 2020 Category: Hematology Source Type: research

Favourable collaterals according to the Careggi Collateral Score grading system in patients treated with thrombectomy for stroke with middle cerebral artery occlusion
AbstractThe ability of the current grading systems to predict optimal outcomes in stroke patients with favourable collaterals remains unexplored. We evaluated differences in the performance of grading systems between Careggi Collateral Score and ASITN/SIR collateral score to predict clinical and radiological outcomes in stroke patients with favourable collaterals who underwent thrombectomy. We included stroke patients receiving thrombectomy within 360  min after symptom onset with MCA occlusion and favourable collaterals (i.e., without poor collaterals) defined by ASITN/SIR collateral score between 2 and 4. Using ordinal ...
Source: Journal of Thrombosis and Thrombolysis - August 18, 2022 Category: Hematology Source Type: research

Early introduction of direct oral anticoagulants in cardioembolic stroke patients with non-valvular atrial fibrillation
AbstractDirect oral anticoagulants (DOACs) are superior to warfarin in reduction of the intracranial bleeding risk. The aim of the present study was to assess whether early DOAC introduction (1 –3 days after onset) in stroke patients with non-valvular atrial fibrillation (nVAF) may be safe and effective, compared with DOAC introduction after 4–7 days. We conducted a prospective analysis based on data collected from 147 consecutive nVAF patients who started DOAC within 7 days after stro ke onset. In all patients, we performed pre-DOAC CT scan 24–36 h after onset and follow-up CT scan at 7 days after DOAC introduction...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2016 Category: Hematology Source Type: research

Safety and efficacy of rt-PA treatment for acute stroke in pseudoxanthoma elasticum: the first report
AbstractPseudoxanthoma elasticum is a rare cause for ischaemic stroke. Little is known about acute and secondary prevention strategies in these subjects given the increased risk of gastrointestinal and urinary bleedings. Here we present the case of a 62  years old man affected by pseudoxanthoma elasticum who presented with acute ischaemic stroke and was successfully treated with intravenous thrombolysis. Neurological signs improved after intravenous thrombolysis without bleeding complication. To our knowledge, this is the first case of pseudoxanth oma elasticum—related stroke undergoing intravenous thrombolysis.
Source: Journal of Thrombosis and Thrombolysis - May 25, 2020 Category: Hematology Source Type: research

Association of the careggi collateral score with radiological outcomes after thrombectomy for stroke with an occlusion of the middle cerebral artery
AbstractWe aimed to examine the association between Careggi Collateral Score (CCS) and radiological outcomes in a large multicenter cohort of patients receiving thrombectomy for stroke with occlusion of middle cerebral artery (MCA). We conducted a study on prospectively collected data from 1785 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. According to the extension of the retrograde reperfusion in the cortical anterior cerebral artery-MCA territories, CCS ranges from 0 (absence of retrograde filling) to 4 (visualization of collaterals until the alar segment of the MCA). Radiological ...
Source: Journal of Thrombosis and Thrombolysis - April 8, 2022 Category: Hematology Source Type: research

Intravenous thrombolysis and endovascular thrombectomy for acute ischaemic stroke in patients with Moyamoya disease - a systematic review and meta-summary of case reports
ConclusionsIn this systematic review and meta-summary, the utility of IVT and ET in MMD-associated AIS appears feasible in selected cases. Further larger cohort studies are required to evaluate these treatment approaches.Highlights· AIS in MMD was typically managed with bypass surgery but not via thrombolysis or thrombectomy.· In this meta-summary, all patients treated with thrombolysis and/or thrombectomy survived and some experienced symptomatic and/or functional improvement.· Further larger cohort studies are necessary for investigating the role of thrombolysis and/or thrombectomy as treatment of AIS in MMD.
Source: Journal of Thrombosis and Thrombolysis - June 14, 2022 Category: Hematology Source Type: research

Tissue plasminogen activator for acute ischemic stroke: calculation of dose based on estimated patient weight can increase the risk of cerebral bleeding
Abstract A dose of 0.9 mg/kg of intravenous tissue plasminogen activator (t-PA) has proven to be beneficial in the treatment of acute ischemic stroke (AIS). Dosing of t-PA based on estimated patient weight (PW) increases the likelihood of errors. Our objectives were to evaluate the accuracy of estimated PW and assess the effectiveness and safety of the actual applied dose (AAD) of t-PA. We performed a prospective single-center study of AIS patients treated with t-PA from May 2010 to December 2011. Dose was calculated according to estimated PW. Patients were weighed during the 24 h following treatment with t-PA. ...
Source: Journal of Thrombosis and Thrombolysis - May 21, 2015 Category: Hematology Source Type: research

Vitamin K antagonists: relative strengths and weaknesses vs. direct oral anticoagulants for stroke prevention in patients with atrial fibrillation
This article reviews and highlights real and perceived implications of VKAs for the prevention of stroke in patients with non-valvular AF, with specific reference to their strengths and weaknesses compared with DOACs.
Source: Journal of Thrombosis and Thrombolysis - November 27, 2016 Category: Hematology Source Type: research

Laboratory measurement of apixaban using anti-factor Xa assays in acute ischemic stroke patients with non-valvular atrial fibrillation
In conclusion, we determined the trough and peak levels of AFXaA in patients with NVAF while being treated with the apixa ban in Korea. Our results could be used as a starting point when setting the reference ranges for laboratories using anti-Xa assay. Large-scale studies are needed to establish the reference range for AFXaA in patients with NVAF.
Source: Journal of Thrombosis and Thrombolysis - December 2, 2017 Category: Hematology Source Type: research

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