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Total 1186 results found since Jan 2013.

Efficacy of Tirofiban Administered at Different Time Points after Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Ischemic Stroke
To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - January 14, 2019 Category: Neurology Authors: Jin Liu, Qiuyan Shi, Yuan Sun, Jingyuan He, Bin Yang, Chunyang Zhang, Rui Guo Source Type: research

Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke
We report a single-center, retrospective assessment of the safety and efficacy of alteplase treatment within 45 minutes. Methods: Five hundred and eighty-six patients were treated with alteplase in our emergency departments (EDs) between January 2014 and October 2016; 368 patients were included for analysis.
Source: Journal of Stroke and Cerebrovascular Diseases - October 9, 2019 Category: Neurology Authors: Sarah Jung, Jamie M. Rosini, Jason T. Nomura, Richard J. Caplan, Jonathan Raser-Schramm Source Type: research

Redefining Early Neurological Improvement After Reperfusion Therapy in Stroke
Background and Purpose: Early neurologic improvement (ENI) in patients treated with alteplase has been shown to correlate with functional outcome. However, the definition of ENI remains controversial and has varied across studies. We hypothesized that ENI defined as a percentage change in the National Institute of Health Stroke Scale (NIHSS) score (percent change NIHSS score) at 24-hours would better correlate with favorable outcomes at 3 months than ENI defined as the change in NIHSS score (delta NIHSS score) at 24 hours.
Source: Journal of Stroke and Cerebrovascular Diseases - December 15, 2019 Category: Neurology Authors: Shashank Agarwal, Shawna Cutting, Brian Mac Grory, Tina Burton, Mahesh Jayaraman, Ryan McTaggart, Michael Reznik, Erica Scher, Andrew D. Chang, Jennifer Frontera, Aaron Lord, Sara Rostanski, Koto Ishida, Jose Torres, Karen Furie, Shadi Yaghi Source Type: research

Familiarization with Contact Aspiration using Non-Penetrating of the Thrombus (CANP) Technique as the Initial Procedure for Acute Ischemic Stroke
Thrombectomy, along with intravenous alteplase, had been the standard medical care to achieve rapid and complete reperfusion for acute ischemic stroke.1 Many devices and techniques had been developed and devised, respectively, to achieve rapid and complete reperfusion. Thrombectomy includes stent retriever thrombectomy, with or without aspiration assistance, and contact aspiration (CA), mainly a direct aspiration first-pass technique (ADAPT). Kang et al. reported CA using a catheter with an inner diameter (I.D.) of 0.041 in.
Source: Journal of Stroke and Cerebrovascular Diseases - September 3, 2021 Category: Neurology Authors: Hiroaki Neki, Takehiro Katano, Takuma Maeda, Aoto Shibata, Hiroyuki Komine, Yuichiro Kikkawa Source Type: research

Caught in Action – Evolving Emergent Large Vessel Occlusion and Collateral Failure During Alteplase Infusion for Acute Ischemic Stroke
Published reports of acute deterioration during alteplase infusion for acute ischemic stroke due to development of partial to complete large vessel occlusion and collateral failure are sparce.
Source: Journal of Stroke and Cerebrovascular Diseases - October 27, 2021 Category: Neurology Authors: Peter S.W. Park, Helen M. Dewey, Philip M.C. Choi Tags: Case Report Source Type: research

Safety of early antiplatelet administration in patients with acute ischemic stroke treated with alteplase (SEAPT-24)
This study aimed to examine the safety of early antiplatelet therapy administration within the first 24 h after alteplase.
Source: Journal of Stroke and Cerebrovascular Diseases - November 5, 2022 Category: Neurology Authors: Drew A. Wells, Lyndsey K. Davis, Omar Saeed, G. Morgan Jones, Cheran Elangovan, Andrei V. Alexandrov, Balaji Krishnaiah, Katherine L. March 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

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), t...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Pre-hospital Triage of Acute Ischemic Stroke Patients —Importance of Considering More Than Two Transport Options
Conclusion: Pre-hospital triage algorithms for AIS patients that only take into account the nearest CSC and the nearest PSC as transport destinations may be unable to identify the optimal transport destination for a significant proportion of patients. Introduction Background International guidelines recommend early administration of intravenous thrombolysis for eligible patients with acute ischemic stroke (AIS); in addition, patients with proximal large vessel occlusion (LVO) should receive mechanical thrombectomy (MT) as quickly as possible (1). As the clinical benefit of both thrombolysis (2–4) and MT (5&#...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Stroke system of care in Louisiana (P6.261)
Conclusions:After LERN’s recognition of stroke facility designations, implementation of education for stroke providers and quality improvement process, the proportion of patients treated with IV tPA has doubled in the state of Louisiana over a 5-year period. LERN’s Statewide stroke system of care has been instrumental in facilitating this progress.Disclosure: Dr. Navalkele has nothing to disclose. Dr. Hargrove has nothing to disclose. Dr. Chernyshev has nothing to disclose. Dr. Acosta has nothing to disclose. Dr. DeAlvare has nothing to disclose. Dr. Hidalgo has nothing to disclose. Dr. El Khoury has nothing to...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Navalkele, D., Hargrove, P., Chernyshev, O., Acosta, J., DeAlvare, L., Hidalgo, G., El Khoury, R., Martin-Schild, S. Tags: Cerebrovascular Disease Systems of Care and Health Policy Source Type: research

Lori’s Stroke Required Help From Doctors An Hour Away. Telemedicine Provided It.
Editor’s note: Our previous stories this American Stroke Month featured warning signs heeded and missed. Today we shift gears to showcase a textbook response to a stroke, including the crucial role of telestroke, a way for experts at another facility to help care for a patient via a webcam-type connection. The CHRONIC Care Act, which includes a provision to require Medicare to cover telestroke, will be discussed Tuesday during a hearing of the Senate Finance Committee. Lori Hoopingarner savored her occasional weekend getaway. Between running her financial advising company, raising a 10-year-old daughter and 6-year-old s...
Source: Healthy Living - The Huffington Post - May 15, 2017 Category: Consumer Health News Source Type: news