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Improvement of Functional Outcomes in Patients with Stroke who Received Alteplase for Over 15 Years: Japan Stroke Data Bank
CONCLUSIONS: We revealed that IVT implementation rates in patients with AIS increased, and the functional outcome in these patients improved over 15 years. Therefore, the Japanese IVT dissemination strategy is considered appropriate and effective.PMID:37587045 | DOI:10.5551/jat.64200
Source: Journal of Atherosclerosis and Thrombosis - August 16, 2023 Category: Cardiology Authors: Akiko Ishigami Kazunori Toyoda Michikazu Nakai Sohei Yoshimura Shinichi Wada Yusuke Sasahara Kazutaka Sonoda Kaori Miwa Junpei Koge Masayuki Shiozawa Yoshitaka Iwanaga Yoshihiro Miyamoto Jin Nakahara Norihiro Suzuki Shotai Kobayashi Kazuo Minematsu Masato Source Type: research

Update on Large-Vessel Revascularization in Acute Ischemic Stroke
AbstractPurpose of reviewThis review presents the critical appraisal of current therapeutic strategies for patients with large-vessel occlusion (LVO) acute ischemic stroke (AIS). We provide the reader with most recent evidence supporting endovascular thrombectomy (EVT), different techniques used for thrombectomy, and highlight knowledge gaps regarding therapeutic efficacy of this intervention in respective subgroup of these patients based on site of occlusion, size of ischemic core, time from symptom onset, utility of concurrent intravenous thrombolysis (IVT), mild strokes, or tandem occlusions.Recent findingsEVT is the es...
Source: Current Treatment Options in Neurology - July 1, 2023 Category: Neurology Source Type: research

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

2016–2017 clinical trials in cerebrovascular neurosurgery
Publication date: Available online 24 October 2018Source: Journal of Clinical NeuroscienceAuthor(s): Wendy Huang, Rose DuAbstractSeveral clinical trials in cerebrovascular neurosurgery were published during 2016–2017. The Collaborative Unruptured Endovascular versus Surgery Trial (CURES) found no difference in outcome between clipping versus coiling of unruptured aneurysms after one year. The Flow Diversion in the Treatment of Intracranial Aneurysm Trial (FIAT) was terminated due to safety concerns. Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity after Subarachnoid Hemorrhage Trial (NEWTON) and othe...
Source: Journal of Clinical Neuroscience - October 25, 2018 Category: Neuroscience Source Type: research

Rectus Sheath Hematoma Following Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Cerebral Infarction: A Case Report
A 76-year-old Japanese man was admitted to our department because of aphasia and right hemiparesis. Brain magnetic resonance imaging showed cerebral infarction caused by occlusion of the left middle cerebral artery, and alteplase therapy was started. Thrombectomy was subsequently performed, resulting in recanalization. On day 4 after admission, he complained of epigastric pain when coughing. On day 8, contrast-enhanced computed tomography showed a left abdominal rectus sheath hematoma without extravasation.
Source: Journal of Stroke and Cerebrovascular Diseases - August 16, 2018 Category: Neurology Authors: Tatsuya Ueno, Takashi Nakamura, Hiroki Hikichi, Akira Arai, Chieko Suzuki, Masahiko Tomiyama Tags: Case Report Source Type: research

Outcome of Acute Ischemic Stroke after the Treatment with Edaravone and 0.6 Mg/Kg Alteplase in Japanese Patients with Diabetes
We investigated how diabetes mellitus (DM) affects the outcome of acute ischemic stroke (AIS), comparing with the outcomes in those who had hypertension (HT) and atrial fibrillation (AF).
Source: Journal of Stroke and Cerebrovascular Diseases - January 18, 2018 Category: Neurology Authors: Norio Tanahashi, Takenori Yamaguchi, Hideto Awano, Hiroaki Matsuda Source Type: research

Clinical Study of Intravenous, Low-Dose Recombinant Tissue Plasminogen Activator for Acute Cerebral Infarction: Comparison of Treatment within 3  Hours versus 3-4.5 Hours
An intravenous recombinant tissue plasminogen activator (rt-PA, alteplase .6  mg/kg) for acute cerebral infarction within 3 hours of onset was approved in Japan in 2005. The treatment window was subsequently extended to within 4.5 hours of onset. However, few Japanese studies have compared the efficacy and safety of rt-PA therapy between patients treated within 3 hou rs and patients treated within 3-4.5 hours.
Source: Journal of Stroke and Cerebrovascular Diseases - December 5, 2017 Category: Neurology Authors: Ichiro Deguchi, Norio Tanahashi, Masaki Takao Source Type: research