• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Association Between Dispatch Complaint and Critical Prehospital Time Intervals in Suspected Stroke 911 Activations in the National Emergency Medical Services Information System, 2012 –2016
Stroke, one of the leading causes of death and disability in the United States (US), is a time sensitive emergency.1 Receiving timely treatment is associated with increased survival and better outcomes.2 –5 For every minute that treatment is delayed, a patient with stroke may lose an estimated 1.9 million neurons, leading to irreversible brain tissue damage long term disability, or death.6 Several studies have demonstrated that treatment with intravenous recombinant tissue-type plasminogen activat or (IV alteplase) can positively affect clinical outcomes when administered within a critical timeframe after ischemic stroke symptom onset.
Source: Journal of Stroke and Cerebrovascular Diseases - December 24, 2021 Category: Neurology Authors: Amena Y. Abbas, Erika C. Odom, Isaac Nwaise Source Type: research

Outcomes with IV tenecteplase and IV alteplase for acute ischemic stroke with or without thrombectomy in real-world settings in the United States
Although many stroke centers in United States are using intravenous (IV) tenecteplase (TNK) for acute ischemic stroke patients, there is paucity of comparative data between IV TNK and IV alteplase from real-world settings.
Source: Journal of Stroke and Cerebrovascular Diseases - December 6, 2022 Category: Neurology Authors: Adnan I. Qureshi, William I. Baskett, Navpreet K. Bains, Brandi R. French, Farhan Siddiq, Camilo R. Gomez, Chi-Ren Shyu Source Type: research

Acute ischemic stroke: improving access to intravenous tissue plasminogen activator.
This article gives an overview of the recent approaches pursued to improve access to alteplase for acute ischemic stroke patients. Utilization of stroke systems of care, quality metrics, and quality improvement initiatives to improve alteplase treatment rates are discussed. The implementation of Telestroke networks to improve access and timely evaluation by a stroke specialist are also reviewed. Lastly, this review discusses the use of neuroimaging techniques to identify alteplase candidates in stroke of unknown symptom onset or beyond the 4.5-hour treatment window.Expert commentary: Expanding access to alteplase therapy f...
Source: Expert Review of Cardiovascular Therapy - April 25, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Nerve stimulation could provide new treatment option for most common type of stroke
Research led by a UCLA scientist found that a new nerve stimulation therapy to increase blood flow could help patients with the most common type of stroke up to 24 hours after onset.A study of 1,000 patients found evidence that the technique, called active nerve cell cluster stimulation, reduced the patients ’ degree of disability three months after they suffered an acute cortical ischemic stroke, which affects the surface of the brain.Dr. Jeffrey Saver, director of theUCLA Comprehensive Stroke Center, was the co-principal investigator of the study, which was conducted at 73 medical centers in 18 countries.“We believe ...
Source: UCLA Newsroom: Health Sciences - May 24, 2019 Category: Universities & Medical Training Source Type: news

Novel Use of a Nurse-Led Telemedicine Team in Acute Stroke: A Retrospective Review of the Impact on a Regional Health Care System
ConclusionIn an acute stroke telemedicine system, implementation of a local nurse-led “stroke responder” system resulted in significantly decreased acute stroke metrics for a community hospital within a regional hospital system.
Source: Journal of Emergency Nursing - September 6, 2018 Category: Nursing Source Type: research

A Nursing Approach to Improving Critical Care Compliance With Vital Signs and Neurological Assessments in Post-IV-Alteplase Stroke Patients
Ischemic stroke represents 87% of all strokes. As global initiatives move forward with stroke care, health care providers and institutions will be called on to deliver the most current evidence-based care. The American Heart Association/American Stroke Association (AHA/ASA) estimates that 795 000 strokes occur each year; 610 000 are new strokes, and 185 000 are recurrent strokes. Eighty-seven percent are ischemic strokes; the overall mortality rate from stroke was 273 000, which makes stroke the fifth leading cause of death and the leading cause of disability in the United States. Stroke costs the United States an estimate...
Source: Critical Care Nursing Quarterly - August 23, 2022 Category: Nursing Tags: Original Articles Source Type: research

Network Mapping of Time to Antithrombotic Therapy Among Patients With Ischemic Stroke and Transient Ischemic Attack (TIA)
Conclusion: The proportion of patients receiving antithrombotics within 48 h was higher than previously reported in Australia but remained lower than the standard achieved in North American hospitals. Our process map and network analysis show avenues to shorten the time to antithrombotic.
Source: Frontiers in Neurology - June 7, 2021 Category: Neurology Source Type: research

Novel Use of a Nurse-Led Telemedicine Team in Acute Stroke: A Retrospective Review of the Impact on a Regional Health Care System
Despite the increasing incidence of acute ischemic stroke in the United States, many health care facilities remain unprepared to manage patients with acute stroke, including the administration of intravenous alteplase (recombinant tissue plasminogen activator [rTPA]). This has led to an opportunity for telemedicine systems to facilitate these evaluations and acute medical stroke treatment decisions. However, even telemedicine systems can fail to provide timely evaluation and management of the patient with acute stroke.
Source: Journal of Emergency Nursing: JEN - September 5, 2018 Category: Nursing Authors: Susan B. Fowler, Christian A. Rosado, Jennifer Jones, Suzanne Ashworth, Darlene Adams Tags: Clinical Article Source Type: research

Tenecteplase for Acute Ischemic Stroke Treatment
Semin Neurol DOI: 10.1055/s-0040-1722722The introduction of thrombolytic therapy in the 1990s has transformed acute ischemic stroke treatment. Thus far, intravenous recombinant tissue plasminogen activator (rt-PA) also known as alteplase is the only thrombolytic proven to be efficacious and approved by the United States Food and Drug Administration. But the thrombolytic agent tenecteplase (TNK) is emerging as a potential replacement for rt-PA. TNK has greater fibrin specificity, slower clearance, and higher resistance to plasminogen activator inhibitor-1 than rt-PA. Hence, TNK has the potential to provide superior lysis wi...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: Baird, Alison E. Jackson, Richard Jin, Weijun Tags: Review Article Source Type: research

Acute Treatment of Ischemic Stroke
This article outlines the evidence to support intravenous thrombolysis with alteplase and tenecteplase, thrombolysis in the setting of DWI/flair mismatch, endovascular treatment in the 6-hour and 6- to 24-hour window, and the use of telemedicine in acute stroke. Current controversies and ongoing trials within endovascular treatment are also detailed. Case presentations are included to provide clinical context and the application of data to practice.
Source: Neurologic Clinics - November 17, 2021 Category: Neurology Authors: Stephanie Lyden, Jana Wold Source Type: research

Intravenous Thrombolytics in the Treatment of Acute Ischemic Stroke
AbstractPurpose of ReviewTo review the current evidence and ongoing clinical trials evaluating the efficacy and safety of tenecteplase (TNK), an alternative tissue plasminogen activator (tPA), in the acute management of arterial ischemic stroke (AIS). To date, alteplase is the only tPA approved by the United States FDA for use in AIS.Recent FindingsThere have been multiple phase two and three trials investigating the safety and efficacy of TNK in AIS. In patients with AIS due to large vessel occlusion, one randomized controlled trial demonstrated superiority of TNK for vessel recanalization rates and long-term functional o...
Source: Current Treatment Options in Cardiovascular Medicine - January 2, 2023 Category: Cardiology Source Type: research

Outcomes with IV tenecteplase and IV alteplase for acute ischemic stroke with or without thrombectomy in real-world settings in the United States
J Stroke Cerebrovasc Dis. 2022 Dec 6;32(2):106898. doi: 10.1016/j.jstrokecerebrovasdis.2022.106898. Online ahead of print.NO ABSTRACTPMID:36493706 | DOI:10.1016/j.jstrokecerebrovasdis.2022.106898
Source: Atherosclerosis - December 9, 2022 Category: Cardiology Authors: Adnan I Qureshi William I Baskett Navpreet K Bains Brandi R French Farhan Siddiq Camilo R Gomez Chi-Ren Shyu Source Type: research

Economic evaluation of intravenous alteplase for stroke with the time of onset between 4.5 and 9 hours
Conclusion For patients with AIS with a time of onset between 4.5 and 9 hours, perfusion imaging-guided intravenous alteplase was likely to be cost-effective in China and was cost-effective in the US when compared with placebo.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Chen, J., Liang, X., Tong, X., Han, M., Ji, L., Zhao, S., Hu, Z., Liu, A. Tags: Open access, Socioeconomics Source Type: research

P-030 Mechanical thrombectomy in medium vessel occlusions using the novel aspiration MIVI Q catheters: an international multicenter experience
ConclusionsTreatment of MeVO patients with Q catheters resulted in optimal angiographic and clinical outcomes. Though angiographic results were similar between primary and secondary MeVOs, the first had less severe presentation and better outcomes at 90-days than the latter.Disclosures A. Monteiro: None. L. Makalanda: None. J. Wareham: None. J. Jones: None. P. Dhillon: None. P. Bhogal: None. W. Brinjikji: None. M. Mokin: None. A. Siddiqui: 1; C; Co-investigator for NIH – 1R01EB030092–01, Project Title: High Speed Angiography at 1000 frames per second; Mentor for Brain Aneurysm Foundation Carol W. Harvey Chair o...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Monteiro, A., Makalanda, L., Wareham, J., Jones, J., Dhillon, P., Bhogal, P., Brinjikji, W., Mokin, M., Siddiqui, A. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research