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Condition: Thrombosis
Management: National Institutes of Health (NIH)

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Total 90 results found since Jan 2013.

O-011 Symptomatic Intracranial Hemorrhage After Reperfusion Therapy - Impact of Definition on its Frequency
ConclusionUnder the trial definition, any apparent extravascular blood in the brain or cranium with an increase of 4 or more on the NIHSS, associated or not, is considered a sICH; as a result, the inclusion of hemorrhagic infarctions (HI1 and HI2) in this definition resulted in an apparent relative increase in sICH rates. Subjecting the THERAPY cohort to other definitions yielded notable variance in complication rates. As there is no current standardization for the quantification of sICH, further analysis and data are needed to identify and standardize a succinct and relevant definition.DisclosuresR. von Kummer: 2; C; Penu...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Frei, D., Yoo, A., Zaidat, O., Khatri, P., Gupta, R., Lopes, D., Shownkeen, H., Meyer, D., Buell, H., Bach, V., Kuo, S., Bose, A., Sit, S., Mocco, J. Tags: Oral abstracts Source Type: research

O-025 The Superiority of Thrombectomy over IV rtPA Monotherapy May be Associated with Thrombus Length - Results of the THERAPY Trial
ConclusionExtensive thrombus burden presents a challenge for stroke intervention, posing greater risk of complications and poor clinical outcome. However, this effect is dampened when IAT is the interventional modality, leading to a more favorable prognosis over IV-rtPA alone. This study finding supports the use of aspiration thrombectomy in treatment of extended thrombi, demonstrating relative advantages over thrombolytic monotherapy, and enables better clinical outcomes.DisclosuresR. von Kummer: 2; C; Penumbra, Inc. J. Mocco: 1; C; Penumbra, Inc. O. Zaidat: 6; C; Penumbra, Inc. P. Khatri: 1; C; Penumbra, Inc. R. Gupta: 6...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: von Kummer, R., Mocco, J., Zaidat, O., Khatri, P., Gupta, R., Frei, D., Lopes, D., Shownkeen, H., Berkhemer, O., Meyer, D., Chauke, M., Hak, S., Kuo, S., Buell, H., Bose, A., Sit, S., Yoo, A. Tags: Oral abstracts Source Type: research

International benchmarking for acute thrombolytic therapy implementation in Australia and Japan
Publication date: July 2016 Source:Journal of Clinical Neuroscience, Volume 29 Author(s): Hiroyuki Kawano, Christopher Levi, Yuichiro Inatomi, Heather Pagram, Erin Kerr, Andrew Bivard, Neil Spratt, Ferdinand Miteff, Toshiro Yonehara, Yukio Ando, Mark Parsons Although a wide range of strategies have been established to improve intravenous tissue plasminogen activator (IV-tPA) treatment rates, international benchmarking has not been regularly used as a systems improvement tool. We compared acute stroke codes (ASC) between two hospitals in Australia and Japan to study the activation process and potentially improv...
Source: Journal of Clinical Neuroscience - May 29, 2016 Category: Neuroscience Source Type: research

Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation
In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressur...
Source: Neuroscience Bulletin - March 7, 2016 Category: Neuroscience Source Type: research

Use of the Direct Oral Anticoagulants in Obese Patients: guidance from the SSC of the ISTH
This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - February 29, 2016 Category: Hematology Authors: K Martin, J Beyer‐Westendorf, BL Davidson, MV Huisman, PM Sandset, S Moll Tags: Recommendations and Guidelines Source Type: research

Direct admission to stroke centers reduces treatment delay and improves clinical outcome after intravenous thrombolysis
Publication date: Available online 9 January 2016 Source:Journal of Clinical Neuroscience Author(s): Dae-Hyun Kim, Hee-Joon Bae, Moon-Ku Han, Beom Joon Kim, Sang-Soon Park, Tai Hwan Park, Kyung Bok Lee, Kyusik Kang, Jong-Moo Park, Youngchai Ko, Soo Joo Lee, Jay Chol Choi, Joon-Tae Kim, Ki-Hyun Cho, Keun-Sik Hong, Yong-Jin Cho, Dong-Eog Kim, Jun Lee, Juneyoung Lee, Mi Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Hyun-Wook Nah, Jae-Kwan Cha We aimed to examine whether direct access to hospitals offering intravenous thrombolysis is associated with functional outcomes in patients with acute ischemic stroke tr...
Source: Journal of Clinical Neuroscience - January 11, 2016 Category: Neuroscience Source Type: research

Long-term outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients
Abstract Cerebral venous thrombosis (CVT) affects mainly working-aged individuals. Functional recovery after CVT is generally considered good with about 3/4 of patients achieving short-term independence. However, vascular events, long-term functional outcome, and employment after CVT remain poorly investigated. We identified consecutive adult CVT patients treated at the Helsinki University Hospital (1987–2013) and invited them to a follow-up visit. Each clinical examination was combined with interview. We also recorded recurrent venous thromboembolism (VTE) and hemorrhagic events during follow-up and antithrombo...
Source: Journal of Neurology - January 2, 2016 Category: Neurology Source Type: research

Complex decision-making in stroke: preoperative mechanical thrombectomy of septic embolus for emergency cardiac valve surgery
We report a case of cardioembolic stroke in a patient with enterococcal endocarditis, with National Institutes of Health Stroke Scale score of 3. A middle-aged patient with bacterial endocarditis exhibited mild intermittent left hemiparesis and dysarthria in the setting of severe aortic insufficiency requiring urgent aortic valve replacement. Cerebrovascular imaging revealed a partially occlusive thrombus in the M1 segment of the right middle cerebral artery, which became symptomatic during relative hypotension. Given the expected hypotension during the urgently needed aortic valve replacement, there was a significant risk...
Source: Journal of NeuroInterventional Surgery - November 13, 2015 Category: Neurosurgery Authors: Ladner, T. R., Davis, B. J., He, L., Kirshner, H. S., Froehler, M. T., Mocco, J. Tags: Electronic pages Source Type: research

Current trends in the management of acute ischemic stroke
Srinivasan ParamasivamNeurology India 2015 63(5):665-672Stroke is the leading cause of disability and most of the cases are those of ischemic stroke. Management strategies especially for large vessel occlusive stroke have undergone a significant change in the recent years that include widespread use of thrombolytic medications followed by endovascular clot removal. For successful treatment by endovascular thrombectomy, the important factors are patient selection based on clinical criterion including age, time of onset, premorbid clinical condition, co-morbidities, National Institute of Health Stroke Scale, and imaging crit...
Source: Neurology India - October 6, 2015 Category: Neurology Authors: Srinivasan Paramasivam Source Type: research

Critical Early Thrombolytic and Endovascular Reperfusion Therapy for Acute Ischemic Stroke Victims: a Call for Adjunct Neuroprotection
This article has 3 main goals: (1) first to emphasize the utility and cost-effectiveness of rt-PA to treat stroke; (2) second to review the recent endovascular trials with respect to efficacy, safety, and cost-effectiveness as a stroke treatment; and (3) to further consider and evaluate strategies to develop novel neuroprotective drugs. A thesis will be put forth so that future stroke trials and therapy development can optimally promote recovery so that stroke victims can return to “normal” life.
Source: Translational Stroke Research - August 29, 2015 Category: Neurology Source Type: research

Influence of previous physical activity on the outcome of patients treated by thrombolytic therapy for stroke
Abstract Physical activity prevents stroke and is associated with less severe strokes. The neuroprotective effect in patients treated with intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA), remains uncertain. We aimed at evaluating the relationship between previous physical activity and outcomes in stroke patients treated with i.v. rt-PA. OPHELIE-SPORT was a prospective observational multicenter study conducted in French and Japanese stroke patients treated with i.v. rt-PA. We evaluated the presence, weekly duration (<2, 2–5, >5 h) and intensity (light, moderate, heavy) of previous leisu...
Source: Journal of Neurology - August 14, 2015 Category: Neurology Source Type: research

Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Publication date: Available online 30 April 2015 Source:The Lancet Neurology Author(s): Gregory W Albers , Rüdiger von Kummer , Thomas Truelsen , Jens-Kristian S Jensen , Gabriela M Ravn , Bjørn A Grønning , Hugues Chabriat , Ku-Chou Chang , Antonio E Davalos , Gary A Ford , James Grotta , Markku Kaste , Lee H Schwamm , Ashfaq Shuaib Background Current treatment of ischaemic stroke with thrombolytic therapy is restricted to 3–4·5 h after symptom onset. We aimed to assess the safety and efficacy of desmoteplase, a fibrin-dependent plasminogen activator, given between 3 h and 9 h after symptom onset in patients with ...
Source: The Lancet Neurology - May 1, 2015 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

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

Effect of intermittent pneumatic compression on disability, living circumstances, quality of life, and hospital costs after stroke: secondary analyses from CLOTS 3, a randomised trial
Publication date: December 2014 Source:The Lancet Neurology, Volume 13, Issue 12 Background The results of the CLOTS 3 trial showed that intermittent pneumatic compression (IPC) reduced the risk of deep vein thrombosis and improved survival in immobile patients with stroke. IPC is now being widely used in stroke units. Here we describe the disability, living circumstances, quality of life, and hospital costs of patients in CLOTS 3. Methods In CLOTS 3, a parallel group trial in 94 UK hospitals, immobile patients with stroke from days 0 to 3 of admission were assigned with a computer-generated allocation sequence in a 1:1 r...
Source: The Lancet Neurology - December 8, 2014 Category: Neurology Source Type: research