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Condition: Hemorrhagic Stroke
Therapy: Thrombolytic Therapy

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Total 340 results found since Jan 2013.

Combination Approaches to Attenuate Hemorrhagic Transformation After tPA Thrombolytic Therapy in Patients with Poststroke Hyperglycemia/Diabetes.
Abstract To date, tissue type plasminogen activator (tPA)-based thrombolytic stroke therapy is the only FDA-approved treatment for achieving vascular reperfusion and clinical benefit, but this agent is given to only about 5% of stroke patients in the USA. This may be related, in part, to the elevated risk of symptomatic intracranial hemorrhage, and consequently limited therapeutic time window. Clinical investigations demonstrate that poststroke hyperglycemia is one of the most important risk factors that cause intracerebral hemorrhage and worsen neurological outcomes. There is a knowledge gap in understanding the ...
Source: Advances in Pharmacology - October 15, 2014 Category: Drugs & Pharmacology Authors: Fan X, Jiang Y, Yu Z, Yuan J, Sun X, Xiang S, Lo EH, Wang X Tags: Adv Pharmacol Source Type: research

Post-Thrombolysis Hemorrhage Risk of Unruptured Intracranial Aneurysms
Conclusion: Intravenous thrombolysis was safe among patients with acute ischemic stroke and incidental unruptured IAs. Future prospective studies with much larger sample sizes are required to clarify the significance of the association between pre-existing unruptured IAs and the development of post-thrombolysis ICH.Eur Neurol 2015;73:37-43
Source: European Neurology - November 7, 2014 Category: Neurology Source Type: research

Statin Use and Brain Hemorrhage Real Risk or Unfounded Fear?
The relationship between statin use and intracerebral hemorrhage (ICH) has not been definitively established. Studies show both benefit and detriment. Statins may decrease the level of platelet aggregation and thrombogenesis and thus worsen an ICH, but they also modulate the immune system, inhibit the inflammatory process, and improve cerebral blood flow, promoting neuroprotection and tissue recovery. Despite physiological and clinical evidence on both sides of the argument, the idea that statins should be avoided whenever brain hemorrhage is involved has permeated stroke practice. Indeed, early and more recent epidemiolog...
Source: JAMA Neurology - November 1, 2014 Category: Neurology Source Type: research

Efficacy of Solitaire™ Stent Arterial Embolectomy in Treating Acute Cardiogenic Cerebral Embolism in 17 Patients.
CONCLUSIONS Solitaire stent embolectomy is a safe and effective alternative to simple venous thrombolytic therapy, and it can significantly improve short-term neurological function and long-term prognosis in acute cardiogenic cerebral embolism. PMID: 27090916 [PubMed - in process]
Source: Medical Science Monitor - April 20, 2016 Category: Research Tags: Med Sci Monit Source Type: research

Low Cholesterol Levels Increase Symptomatic Intracranial Hemorrhage Rates After Intravenous Thrombolysis: A Multicenter Cohort Validation Study.
CONCLUSIONS: This study supports the strong association between reduced LDL-C and increased SICH, but not for functional outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. LDL-C level of ＜130 mg/dL is supposed to a candidate marker for predicting SICH within 24-36 h. PMID: 30464112 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - November 24, 2018 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Assessment of recombinant tissue plasminogen activator (rtPA) toxicity in cultured neural cells and subsequent treatment with poly-arginine peptide R18D.
Abstract Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischaemic stroke has been associated with neurotoxicity, blood brain barrier (BBB) disruption and intra-cerebral hemorrhage. To examine rtPA cellular toxicity we investigated the effects of rtPA on cell viability in neuronal, astrocyte and brain endothelial cell (bEnd.3) cultures with and without prior exposure to oxygen-glucose deprivation (OGD). In addition, the neuroprotective peptide poly-arginine-18 (R18D; 18-mer of D-arginine) was examined for its ability to reduce rtPA toxicity. Studies demonstrated that a 4- or 24-h expos...
Source: Neurochemical Research - March 4, 2020 Category: Neuroscience Authors: Kenna JE, Anderton RS, Knuckey NW, Meloni BP Tags: Neurochem Res Source Type: research

P-007 Safety and efficacy of endovascular thrombectomy for distal vessel occlusion (DLV): single center experience
ConclusionThis single center, consecutive real-world experience demonstrates that thrombectomy in DVO stroke patients is safe and leads to high rate of successful recanalization. Further studies are warranted to evaluate the efficacy of thrombectomy in DVO in comparison to best medical management.Disclosures S. Majidi: None. S. Matsoukas: None. R. De Leacy: None. T. Oxley: None. H. Shoirah: None. T. Shigematsu: None. C. Kellner: None. J. Fifi: None. J. Mocco: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Majidi, S., Matsoukas, S., De Leacy, R., Oxley, T., Shoirah, H., Shigematsu, T., Kellner, C., Fifi, J., Mocco, J. Tags: Oral poster abstracts Source Type: research

Is a Routine Head CT after IV-tPA Therapy Medically Necessary? (P03.170)
CONCLUSIONS: In clinical practice, the risk of symptomatic ICH after IV-tPA is low. GRASPS scores may be helpful in identifying patients at higher risk for ICH but it is not sufficiently sensitive to guide a selective use for post-therapy surveillance imaging. A protocol requiring repeat neuroimaging at 24 hr after IV-tPA is not supported by clinical practice data. Neuroimaging after IV-tPA should focus on vascular imaging needed for determining the mechanism and treatment plan and to evaluate the cause of clinical deterioration after therapy.Disclosure: Dr. Sehgal has nothing to disclose. Dr. Mehndiratta has nothing to di...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Sehgal, S., Mehndiratta, P., Talahma, M., Eisele, S., Sila, C. Tags: P03 Cerebrovascular Disease III Source Type: research

IMM‐H004 prevents toxicity induced by delayed treatment of tPA in a rat model of focal cerebral ischemia involving PKA‐and PI3K‐dependent Akt activation
Abstract Ischemic stroke is currently treated with thrombolytic therapy with a drawback to induce hemorrhagic transformation (HT) if applied beyond its relatively narrow treatment time window. The present study was designed to examine the role of IMM‐H004, a derivative of coumarin, in recombinant tissue plasminogen activator (tPA)‐induced HT. Rats subjected to 6 h of thromboembolic occlusion or middle cerebral artery occlusion received tPA with or without IMM‐H004. Delayed tPA intervention drastically increased the risk of HT and exaggerated the ischemic injury. To assess the effect of IMM‐H004 on delayed treatmen...
Source: European Journal of Neuroscience - March 20, 2014 Category: Neuroscience Authors: Wei Zuo, Jiao Chen, Shuai Zhang, Jia Tang, Hang Liu, Dongming Zhang, Naihong Chen Tags: Research Report Source Type: research

Bryostatin extends tPA time window to 6 h following middle cerebral artery occlusion in aged female rats.
Abstract Blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) following ischemic /reperfusion injury contributes to post-stroke morbidity and mortality. Bryostatin, a potent protein kinase C (PKC) modulator, has shown promise in treating neurological injury. In the present study, we tested the hypothesis that administration of bryostatin would reduce BBB disruption and HT following acute ischemic stroke; thus, prolonging the time window for administering recombinant tissue plasminogen activator (r-tPA). Acute cerebral ischemia was produced by reversible occlusion of the right middle cerebral ar...
Source: European Journal of Pharmacology - July 16, 2015 Category: Drugs & Pharmacology Authors: Tan Z, Lucke-Wold BP, Logsdon AF, Turner RC, Tan C, Li X, Hongpaison J, Alkon DL, Simpkins JW, Rosen CL, Huber JD Tags: Eur J Pharmacol Source Type: research

Thrombolytic therapy for pulmonary embolism.
CONCLUSIONS: There is low quality evidence that thrombolytics reduce death following acute pulmonary embolism compared with heparin. Furthermore, thrombolytic therapies included in the review were heterogeneous. Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events and stroke. More high quality double blind RCTs assessing safety and cost-effectiveness are required. PMID: 26419832 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 30, 2015 Category: Journals (General) Authors: Hao Q, Dong BR, Yue J, Wu T, Liu GJ Tags: Cochrane Database Syst Rev Source Type: research

Analysis on the correlation factors for hemorrhagic transformation after intravenous thrombolytic therapy.
CONCLUSIONS: Intravenous thrombolysis hemorrhagic transformation associated with these factors including the vessel wall, blood composition and biochemical markers. PMID: 25855925 [PubMed - indexed for MEDLINE]
Source: Pharmacological Reviews - November 20, 2015 Category: Drugs & Pharmacology Authors: Zhang PL, Wang YX, Chen Y, Zhang CH, Li CH, Dong Z, Zhang SS, Tong YF, Li YQ, Tong XG, Wang JH Tags: Eur Rev Med Pharmacol Sci Source Type: research

Sonothrombolysis.
Authors: Meairs S Abstract Ultrasound (US) applied as an adjunct to thrombolytic therapy improves the recanalization of occluded vessels, and microbubbles can amplify this effect. New data suggests that the combination of US and microbubbles without tissue plasminogen activator may achieve recanalization with a lower risk of hemorrhage. Further possibilities include specific targeting of thrombus with immunobubbles as well as local drug delivery with US-sensitive liposomes. Clinical studies support the use of US for ischemic stroke therapy, and the first trials of enhancing sonothrombolysis with microbubbles have b...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

The effect of HMG-CoA reductase inhibitors on thrombolysis-induced haemorrhagic transformation
Publication date: Available online 11 September 2019Source: Journal of Clinical NeuroscienceAuthor(s): Yousheng Wu, Dan Lu, Anding XuAbstractThrombolysis-induced haemorrhagic transformation is the most challenging preventable complication in thrombolytic therapy. This condition is often associated with poor functional outcome and long-term disease burden. Statins, or 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, are controversially suggested to either increase or decrease the odds of better primary outcomes compared to treatment without statins after thrombolysis in patients or animals; statins are ...
Source: Journal of Clinical Neuroscience - September 12, 2019 Category: Neuroscience Source Type: research

Thrombolytic therapy for pulmonary embolism
CONCLUSIONS: Low-certainty evidence suggests that thrombolytics may reduce death following acute pulmonary embolism compared with heparin (the effectiveness was mainly driven by one trial with massive PE). Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events, including haemorrhagic stroke. More studies of high methodological quality are needed to assess safety and cost effectiveness of thrombolytic therapy for people with pulmonary embolism.PMID:33857326 | DOI:10.1002/14651858.CD004437.pub6
Source: Cochrane Database of Systematic Reviews - April 15, 2021 Category: General Medicine Authors: Zhiliang Zuo Jirong Yue Bi Rong Dong Taixiang Wu Guan J Liu Qiukui Hao Source Type: research