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Specialty: Emergency Medicine
Drug: Activase
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Total 48 results found since Jan 2013.
Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review
ConclusionsThe available evidence suggests that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase.
Source: International Journal of Emergency Medicine - January 4, 2022 Category: Emergency Medicine Source Type: research
Alteplase for Acute Ischemic Stroke Beyond 3 hours: Enthusiasm Outpaces Evidence
Source: Western Journal of Emergency Medicine - April 3, 2021 Category: Emergency Medicine Source Type: research
Utilization of lysis percentage via thromboelastography for tissue plasminogen activator-induced symptomatic intracranial hemorrhage
Alteplase, the only FDA approved tissue plasminogen activator (tPA), remains one of the cornerstones of acute ischemic stroke (AIS) management. Just as with endogenous tPA, recombinant tPA promotes the activation of plasmin and the subsequent degradation of cross-linked fibrin to fibrin byproducts [1]. The most feared complication of recombinant tPA administration is the development of symptomatic intracranial hemorrhage (sICH), which occurs in approximately 5.6% of tPA administrations, utilizing the European Cooperative Acute Stroke Study definition, with roughly half of these cases resulting in death [2].
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Brian W. Gilbert, J. Spencer Dingman, Joel B. Huffman Source Type: research
Tenecteplase for thrombolysis in stroke patients: Systematic review with meta-analysis
Alteplase is an approved treatment for acute ischemic stroke. Tenecteplase is a genetically modified form of alteplase, with lower cost and a more favourable pharmacokinetic profile allowing bolus injection. The aim of this study was to compare both drugs in adult patients with acute ischemic stroke undergoing thrombolysis.
Source: The American Journal of Emergency Medicine - December 24, 2020 Category: Emergency Medicine Authors: M. Oliveira, M. Fidalgo, L. Font ão, J. Antão, S. Marques, V. Afreixo, T. Gregório Source Type: research
Alteplase for Minor Stroke: The AAEM Clinical Practice Advisory is More Accurate Than Other National Guidelines
The American Heart Association (AHA) has recently published an update to their 2018 guidelines for the management of acute ischemic stroke. Compared with the 2018 guidelines, a new class III ( “No Benefit”) recommendation was made for “mild non-disabling stroke” in the 0–3-h time window (1). “Mild disabling stroke,” however, received a class I (“Strong”) recommendation in the 0–3-h window. These guidelines were endorsed by the Society for Academic Emergency Medicine. T he 2015 American College of Emergency Physicians clinical policy does not differentiate their recommendation for the use of alteplase ba...
Source: The Journal of Emergency Medicine - November 1, 2020 Category: Emergency Medicine Authors: Ravi Garg Tags: Letters to the Editor Source Type: research
News: Reanalysis Fires Up Controversy about Alteplase for Stroke
No abstract available
Source: Emergency Medicine News - October 29, 2020 Category: Emergency Medicine Tags: News Source Type: news
Thrombolysis with alteplase 3 –4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances
In patients presenting to the emergency department with acute stroke, previous evidence from the Third European Cooperative Acute Stroke Study (ECASS III) recommended alteplase treatment within 3 to 4.5 hours of symptoms onset. Factors taken into consideration in the original report include time to treatment, history of smoking or hypertension, and an adjusted National Institute of Health Stroke Scale (NIHSS) score. However, it is unclear if accounting for history of stroke and baseline differences in NIHSS score on arrival may alter outcomes in patients given alteplase.
Source: The Journal of Emergency Medicine - October 1, 2020 Category: Emergency Medicine Authors: Anne Kathryn Watson, Amanda Young Tags: Abstract Source Type: research
Impact of Emergency Department Crowding on Delays in Acute Stroke Care
Introduction:Delays in identification and treatment of acute stroke contribute to significant morbidity and mortality. Multiple clinical factors have been associated with delays in acute stroke care. We aimed to determine the relationship between emergency department (ED) crowding and the delivery of timely emergency stroke care.Methods:We used prospectively collected data from our institutional Get with the Guidelines-Stroke registry to identify consecutive acute ischemic stroke patients presenting to our urban academic ED from July 2016 –August 2018. We used capacity logs to determine the degree of ED crowding at the t...
Source: Western Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Source Type: research
Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up?
Alteplase is the only Food and Drug Administration-approved intravenous (IV) thrombolytic medication for acute ischemic stroke. However, multiple recent studies comparing tenecteplase and alteplase suggest that tenecteplase is at least as efficacious as alteplase with regards to neurologic improvement. When given at 0.25 milligrams per kilogram (mg/kg), tenecteplase may have less bleeding complications than alteplase as well. This narrative review evaluates the literature and addresses the practical issues with regards to the use of tenecteplase versus alteplase for acute ischemic stroke, and it recommends that physicians ...
Source: Western Journal of Emergency Medicine - February 24, 2020 Category: Emergency Medicine Source Type: research
Evaluating Target: Stroke guideline implementation on assessment and treatment times for patients with suspected stroke
Immediate ischemic stroke treatment improves outcomes and early alteplase administration is recommended for patients within window. We implemented stroke guidelines through a neuro-resuscitation initiative (NRI) and hypothesized that the intervention would decrease times to assessment and treatment.
Source: The American Journal of Emergency Medicine - February 12, 2020 Category: Emergency Medicine Authors: Danielle Albright, Robert Alunday, Eric Schaller, Huy Q. Tran, Cameron S. Crandall Source Type: research
Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Choosing the Correct “-ase” in Acute Ischemic Stroke: Alteplase, Tenecteplase, and Reteplase
Alteplase is a tissue plasminogen activator approved for treating acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute massive pulmonary embolism. Two additional tissue plasminogen activators, tenecteplase and reteplase, are also approved for AMI treatment. However, neither tenecteplase nor reteplase is approved for AIS treatment. The U.S. Food and Drug Administration has received reports of accidental administration of tenecteplase or reteplase instead of alteplase in patients with AIS, which can lead to potential overdose. Primary factors contributing to medication errors include use of the abbreviat...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research
Effect of Alteplase vs Aspirin on Functional Outcome for Patients with Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial
Alteplase is the standard of care for large ischemic strokes, however there is little evidence for its use in patients with low National Institutes of Health Stroke Scale (NIHSS) scores, as this subgroup of patients has previously been excluded from large clinical trials. However, in view of initial underappreciated deficits and possible stroke progression, patients with low NIHSS scores at presentation could potentially benefit from a more aggressive treatment with alteplase administration.
Source: The Journal of Emergency Medicine - November 1, 2018 Category: Emergency Medicine Authors: Chelsea Dymond Source Type: research
Pharmacoeconomic impact of an alternative workflow process for stroke
The objective of this study was to evaluate a new multidisciplinary process in which intravenous alteplase (tPA) waste, used for acute ischemic stroke (AIS), was salvaged in an attempt to maximize cost effectiveness without impacting door-to-needle (DTN) administration times.
Source: The American Journal of Emergency Medicine - October 16, 2018 Category: Emergency Medicine Authors: Brian W. Gilbert, Joel B. Huffman, Joe Slechta, Christine Porter, John M. Gallagher Source Type: research
Low Dose vs. Standard-Dose Alteplase for Patients With Acute Ischemic Stroke
There is developing data for the use of low-dose intravenous alteplase (0.6mg/kg body weight; maximum 60 mg) compared to standard-dose alteplase (0.9mg/kg body weight; maximum 90 mg), however much of this data has been conflicting, especially across different patient populations. In the recently completed alteplase-dose evaluation arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (Enchanted), low-dose alteplase was not shown to meet the noninferiority margin defined by the modified Rankin score (mRS) compared to standard-dose alteplase.
Source: The Journal of Emergency Medicine - May 1, 2018 Category: Emergency Medicine Authors: Heather Roesly Source Type: research
