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Source: Stroke
Drug: Activase
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Total 49 results found since Jan 2013.
Letter by Niu et al Regarding Article, “Outcome After Reperfusion Therapies in Patients With Large Baseline Diffusion-Weighted Imaging Stroke Lesions: A THRACE Trial (Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke) Subgroup Analysis” Letter to the Editor
Source: Stroke - May 25, 2018 Category: Neurology Authors: Peng-Peng Niu, Bo Song, Yu-Ming Xu Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Letters to the Editor Source Type: research
Response by Oppenheim et al to Letter Regarding Article, “Outcome After Reperfusion Therapies in Patients With Large Baseline Diffusion-Weighted Imaging Stroke Lesions: A THRACE Trial (Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke) Subgroup Analysis” Letter to the Editor
Source: Stroke - May 25, 2018 Category: Neurology Authors: Catherine Oppenheim, Serge Bracard, Francis Guillemin Tags: Magnetic Resonance Imaging (MRI), Prognosis, Treatment, Ischemic Stroke Letters to the Editor Source Type: research
Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database Clinical Sciences
Background and Purpose—Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.Methods—All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I. Lindley, John Chalmers, Craig S. Anderson Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
SCIL-STROKE (Subcutaneous Interleukin-1 Receptor Antagonist in Ischemic Stroke) Clinical Sciences
Background and Purpose—The proinflammatory cytokine IL-1 (interleukin-1) has a deleterious role in cerebral ischemia, which is attenuated by IL-1 receptor antagonist (IL-1Ra). IL-1 induces peripheral inflammatory mediators, such as interleukin-6, which are associated with worse prognosis after ischemic stroke. We investigated whether subcutaneous IL-1Ra reduces the peripheral inflammatory response in acute ischemic stroke.Methods—SCIL-STROKE (Subcutaneous Interleukin-1 Receptor Antagonist in Ischemic Stroke) was a single-center, double-blind, randomized, placebo-controlled phase 2 trial of subcutaneous IL-1Ra (100 mg a...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Craig J. Smith, Sharon Hulme, Andy Vail, Calvin Heal, Adrian R. Parry-Jones, Sylvia Scarth, Karen Hopkins, Margaret Hoadley, Stuart M. Allan, Nancy J. Rothwell, Stephen J. Hopkins, Pippa J. Tyrrell Tags: Inflammation, Treatment, Ischemic Stroke Original Contributions Source Type: research
Long-Term Survival After Intravenous Thrombolysis for Ischemic Stroke Clinical Sciences
Background and Purpose—Intravenous thrombolysis with alteplase is one of the few approved treatments for acute ischemic stroke; nevertheless, little is known about its long-term effects on survival and recovery because clinical trials follow-up times are limited.Methods—Patients registered between January 2005 and December 2015, to the population-based South London Stroke Register of first-ever strokes. Propensity score was used to match thrombolyzed and control cases to a 1:2 ratio by demographical and clinical covariates. The primary outcome was survival up to 10 years using Kaplan–Meier estimates, Cox proportional...
Source: Stroke - February 26, 2018 Category: Neurology Authors: Walter Muruet, Anthony Rudd, Charles D.A. Wolfe, Abdel Douiri Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Outcome After Reperfusion Therapies in Patients With Large Baseline Diffusion-Weighted Imaging Stroke Lesions Brief Report
Conclusions—Stroke patients with DWI lesion>70 mL may benefit from reperfusion therapy, especially those with isolated M1 occlusion or ischemia restricted to the superficial middle cerebral artery territory. The benefit of treatment seems questionable for patients with carotid occlusion or lesion extending to the deep middle cerebral artery territory.
Source: Stroke - February 26, 2018 Category: Neurology Authors: Vincent Gautheron, Yu Xie, Marie Tisserand, Helene Raoult, Sebastien Soize, Olivier Naggara, Romain Bourcier, Sebastien Richard, Francis Guillemin, Serge Bracard, Catherine Oppenheim Tags: Magnetic Resonance Imaging (MRI), Prognosis, Revascularization, Quality and Outcomes, Ischemic Stroke Brief Reports Source Type: research
Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System Clinical Sciences
This study included 310 patients treated with alteplase in the pre–EXpediting the PRrocess of Evaluating and Stopping Stroke period and 557 patients treated with alteplase in the EXpediting the PRrocess of Evaluating and Stopping Stroke period. After implementation, alteplase administrations increased to 62/mo from 34/mo at baseline (P
Source: Stroke - December 22, 2017 Category: Neurology Authors: Mai N. Nguyen-Huynh, Jeffrey G. Klingman, Andrew L. Avins, Vivek A. Rao, Abigail Eaton, Sunil Bhopale, Anne C. Kim, John W. Morehouse, Alexander C. Flint Tags: Treatment, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Purpose—Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment.Methods—A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. The documen...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Shadi Yaghi, Joshua Z. Willey, Brett Cucchiara, Joshua N. Goldstein, Nicole R. Gonzales, Pooja Khatri, Louis J. Kim, Stephan A. Mayer, Kevin N. Sheth, Lee H. Schwamm Tags: Statements and Guidelines AHA/ASA Scientific Statement Source Type: research
Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions Source Type: research
Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke Brief Report
Background and Purpose—Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study).Methods—A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe R...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Susan J. Carr, Xia Wang, Veronica V. Olavarria, Pablo M. Lavados, Jorge A. Rodriguez, Jong S. Kim, Tsong-Hai Lee, Richard I. Lindley, Octavio M. Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K. Sharma, Mark Woodward, John Chalmers, Craig S. Anderson, Tags: Clinical Studies, Intracranial Hemorrhage, Ischemic Stroke Brief Reports Source Type: research
Low- Versus Standard-Dose Alteplase in Patients on Prior Antiplatelet Therapy Clinical Sciences
Conclusions—Low-dose alteplase may improve outcomes in thrombolysis-treated acute ischemic stroke patients on prior APT, but this requires further evaluation in a randomized controlled trial.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01422616.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Thompson G. Robinson, Xia Wang, Hisatomi Arima, Philip M. Bath, Laurent Billot, Joseph P. Broderick, Andrew M. Demchuk, Geoffery A. Donnan, Jong S. Kim, Pablo M. Lavados, Tsong-Hai Lee, Richard I. Lindley, Sheila C. O. Martins, Veronica V. Olavarria, Jeya Tags: Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
Cost of Alteplase Has More Than Doubled Over the Past Decade Brief Report
Conclusions—We found a striking increase in the cost of alteplase over the last decade, with a 100 mg vial now with a CMS payment of ≈$6400, a>100% increase over 10 years. During the same time frame, the DRG base payment to hospitals increased by only 8%, and alteplase cost increased from 27% of the payment in 2006 to 53% in 2013. Researchers and stroke physicians should be aware of these changes in drug costs and their impact on cost-effectiveness analyses.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Dawn Kleindorfer, Joseph Broderick, Bart Demaerschalk, Jeffrey Saver Tags: Cost-Effectiveness, Ischemic Stroke Brief Reports Source Type: research
Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy Clinical Sciences
Background and Purpose—Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication.Methods—All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case–control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging. Exposure variables were imaging (noncontrast computed tomography hypoattenuation degree, relative volume...
Source: Stroke - May 22, 2017 Category: Neurology Authors: Connor Batchelor, Pooneh Pordeli, Christopher D. d’Esterre, Mohamed Naȷm, Fahad S. Al–Aȷlan, Mari E. Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V. Khaw, Michael D. Hill, Tags: Blood-Brain Barrier, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
Delays in Door-to-Needle Times and Their Impact on Treatment Time and Outcomes in Get With The Guidelines-Stroke Clinical Sciences
Conclusions—Hospital and eligibility delays such as delay diagnosis and inability to determine eligibility were associated with longer door-to-needle times. Improved stroke recognition and management of acute comorbidities may help to reduce door-to-needle times.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D. Hill, Deepak L. Bhatt, Jeffrey L. Saver, Mathew J. Reeves, Gregg C. Fonarow, Lee H. Schwamm, Eric E. Smith Tags: Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research
Vessel Wall Enhancement and Blood-Cerebrospinal Fluid Barrier Disruption After Mechanical Thrombectomy in Acute Ischemic Stroke Clinical Sciences
Conclusions—These findings may support the clinical relevance of direct vessel damage and BCSFB disruption after acute stroke and reinforce the need for further improvements in reperfusion strategies. Further validation in larger cohorts of patients is warranted.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Arturo Renu, Carlos Laredo, Antonio Lopez–Rueda, Laura Llull, Raul Tudela, Luis San–Roman, Xabier Urra, Jordi Blasco, Juan Macho, Laura Oleaga, Angel Chamorro, Sergio Amaro Tags: Blood-Brain Barrier, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
