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Outcomes and risk factors of perforating and non-perforating middle cerebral artery infarctions after intravenous thrombolysis
AbstractThe clinical symptoms of perforating arteries differ, and responses to intravenous thrombolytic therapy are heterogeneous. Here, we investigated the effect of intravenous thrombolytic therapy and the related factors influencing acute perforating and non-perforating middle cerebral artery infarctions. We analyzed 320 patients with acute middle cerebral artery infarction who received alteplase thrombolysis within 4.5  h of onset at two stroke centers from January 2016 to December 2019. Outcome measures included rates of a favorable functional outcome (modified Rankin Scale scores of 0–2), distribution of modified ...
Source: Journal of Thrombosis and Thrombolysis - January 14, 2022 Category: Hematology Source Type: research

Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial
Publication date: April 2019Source: The Lancet Neurology, Volume 18, Issue 4Author(s): Andrei V Alexandrov, Martin Köhrmann, Lauri Soinne, Georgios Tsivgoulis, Andrew D Barreto, Andrew M Demchuk, Vijay K Sharma, Robert Mikulik, Keith W Muir, Gordon Brandt, John Alleman, James C Grotta, Christopher R Levi, Carlos A Molina, Maher Saqqur, Dimitris Mavridis, Theodora Psaltopoulou, Milan Vosko, Jochen B Fiebach, Pitchaiah MandavaSummaryBackgroundPulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed ...
Source: The Lancet Neurology - March 16, 2019 Category: Neurology Source Type: research

Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Luis San Román, Bijoy K Menon, Jordi Blasco, María Hernández-Pérez, Antoni Dávalos, Charles B L M Majoie, Bruce C V Campbell, Francis Guillemin, Hester Lingsma, René Anxionnat, Jonathan Epstein, Jeffrey L Saver, Henk Marquering, John H Wong, Demetrius Lopes, Gernot Reimann, Hubert Desal, Diederik W J Dippel, Shelagh Coutts, Richard du Mesnil de RochemontSummaryBackgroundEvidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the associat...
Source: The Lancet Neurology - September 19, 2018 Category: Neurology Source Type: research

Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial
This study is registered with ClinicalTrials.gov, number NCT01949948. Findings Between Sept 1, 2012, and Sept 30, 2016, 1107 patients met the inclusion criteria and seven patients were excluded because informed consent was withdrawn or eligibility for thrombolytic treatment was reconsidered. 1100 patients were randomly assigned to the tenecteplase (n=549) or alteplase (n=551) groups. The median age of participants was 77 years (IQR 64–79) and the median National Institutes of Health Stroke Scale score at baseline was 4 points (IQR 2–8). A final diagnosis other than ischaemic stroke or transient ischaemic attack was fou...
Source: The Lancet Neurology - August 3, 2017 Category: Neurology Source Type: research

Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study
This study is registered with ClinicalTrials.gov, number NCT01472926. Findings Between Jan 1, 2012, and Sept 7, 2013, 355 patients were screened, of whom 157 were eligible for intravenous thrombolysis, and 104 patients were enrolled. 52 were assigned to the alteplase group and 52 to tenecteplase. Of 71 patients (35 assigned tenecteplase and 36 assigned alteplase) contributing to the primary endpoint, no significant differences were noted for percentage of penumbral salvaged (68% [SD 28] for the tenecteplase group vs 68% [23] for the alteplase group; mean difference 1·3% [95% CI −9·6 to 12·1]; p=0·81). Neither incide...
Source: The Lancet Neurology - February 26, 2015 Category: Neurology Source Type: research