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Drip and Ship Thrombolytic Therapy for Acute Ischemic Stroke: Use, Temporal Trends, and Outcomes Clinical Sciences
Conclusions— Drip and ship tPA is common, used in 1 in 4 patients treated with tPA in the United States. Modest differences in mortality and symptomatic intracranial hemorrhage may be because of patient selection bias, post-tPA care differences, or unmeasured confounding. The drip and ship paradigm may facilitate widespread tPA use in patients with acute stroke.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Sheth, K. N., Smith, E. E., Grau-Sepulveda, M. V., Kleindorfer, D., Fonarow, G. C., Schwamm, L. H. Tags: Acute Cerebral Infarction, Acute Stroke Syndromes, Embolic stroke, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Variations in Acute Hospital Stroke Care and Factors Influencing Adherence to Quality Indicators in 6 European Audits Brief Reports
Conclusions— Detected variations in performance of acute stroke services were found. Differences in adherence to quality indicators might indicate population subgroups with specific needs for improving care delivery.
Source: Stroke - January 26, 2015 Category: Neurology Authors: Wiedmann, S., Hillmann, S., Abilleira, S., Dennis, M., Hermanek, P., Niewada, M., Norrving, B., Asplund, K., Rudd, A. G., Wolfe, C. D. A., Heuschmann, P. U., on behalf of the European Implementation Score Collaboration Tags: Health policy and outcome research, Emergency treatment of Stroke, Other Stroke Treatment - Medical Brief Reports Source Type: research

Letter by Turc et al Regarding Article, "Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials" Letters to the Editor
Source: Stroke - January 26, 2015 Category: Neurology Authors: Turc, G., Tisserand, M., Seners, P., Oppenheim, C., Baron, J.-C. Tags: Thrombolysis Letters to the Editor Source Type: research

Response to Letter Regarding Article, "Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials" Letters to the Editor
Source: Stroke - January 26, 2015 Category: Neurology Authors: Rao, N. M., Levine, S. R., Saver, J. L. Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Emergency treatment of Stroke, Intracerebral Hemorrhage, Thrombolysis Letters to the Editor Source Type: research

Initial Body Temperature in Ischemic Stroke: Nonpotentiation of Tissue-Type Plasminogen Activator Benefit and Inverse Association With Severity Clinical Sciences
Conclusions— In patients with hyperacute stroke, higher presenting temperatures are associated with less severe neurological deficits and reduced final infarct volumes. Presenting temperature does not modify the benefit of tPA on 3-month favorable outcome.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Kim, S. H., Saver, J. L. Tags: Thrombolysis Clinical Sciences Source Type: research

Effect of Alteplase Within 6 Hours of Acute Ischemic Stroke on All-Cause Mortality (Third International Stroke Trial) Clinical Sciences
Conclusions— These exploratory analyses of the third International Stroke Trial (IST-3) trial support improving acute stroke patients’ access to earlier alteplase treatment, treatment of patients with poor prognosis, and further randomized controlled trials in minor stroke to replicate these findings. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25765518.
Source: Stroke - November 24, 2014 Category: Neurology Authors: Whiteley, W. N., Thompson, D., Murray, G., Cohen, G., Lindley, R. I., Wardlaw, J., Sandercock, P., on behalf of the IST-3 Collaborative Group Tags: Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Transcranial Laser Therapy in Acute Stroke Treatment: Results of Neurothera Effectiveness and Safety Trial 3, a Phase III Clinical End Point Device Trial Major Clinical Trial
Conclusions— Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. Clinical Trial Registration— URL: http...
Source: Stroke - October 27, 2014 Category: Neurology Authors: Hacke, W., Schellinger, P. D., Albers, G. W., Bornstein, N. M., Dahlof, B. L., Fulton, R., Kasner, S. E., Shuaib, A., Richieri, S. P., Dilly, S. G., Zivin, J., Lees, K. R., for the NEST 3 Committees and Investigators, Broderick, Ivanova, Johnston, Norrvin Tags: Acute Cerebral Infarction Major Clinical Trial Source Type: research

Impact of Living Alone on the Care and Outcomes of Patients With Acute Stroke Brief Reports
Conclusions— Patients living alone had delayed hospital arrival, less thrombolytic therapy, and were less likely to return home. Greater understanding of the inter-relationships among living alone, social isolation, access to stroke care, and outcomes is needed.
Source: Stroke - September 22, 2014 Category: Neurology Authors: Reeves, M. J., Prager, M., Fang, J., Stamplecoski, M., Kapral, M. K. Tags: Acute Stroke Syndromes Brief Reports Source Type: research

Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation Clinical Sciences
Conclusions— This study provides crucial data that patients with ischemic stroke who do not have visible arterial occlusion at presentation may benefit from thrombolysis.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Pettigrew, L. C., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D. S. Tags: Cerebral Lacunes, Embolic stroke, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke, Thrombolysis Clinical Sciences Source Type: research

Defining Clinically Relevant Cerebral Hemorrhage After Thrombolytic Therapy for Stroke: Analysis of the National Institute of Neurological Disorders and Stroke Tissue-Type Plasminogen Activator Trials Clinical Sciences
Conclusions— The ECASS2 and mSITS-MOST symptomatic intracerebral hemorrhage definitions, which combine radiological features and occurrence of substantial early neurological deterioration, best identify tPA hemorrhages that alter final patient outcome.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Rao, N. M., Levine, S. R., Gornbein, J. A., Saver, J. L. Tags: Acute Cerebral Infarction, Emergency treatment of Stroke, Intracerebral Hemorrhage, Thrombolysis Clinical Sciences Source Type: research

Race/Ethnic Differences in the Risk of Hemorrhagic Complications Among Patients With Ischemic Stroke Receiving Thrombolytic Therapy Clinical Sciences
Conclusions— In patients with stroke receiving tPA, hemorrhagic complications were slightly higher in blacks and Asians, but not in Hispanics compared with whites. Asians also faced significantly higher risk for sICH relative to other race/ethnic groups. Future studies are needed to evaluate whether reduction in tPA dose similar to that used in many Asian countries could improve the safety of tPA therapy in Asians in the United States with acute ischemic strokes while maintaining efficacy.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Mehta, R. H., Cox, M., Smith, E. E., Xian, Y., Bhatt, D. L., Fonarow, G. C., Peterson, E. D., for the Get With The Guidelines-Stroke Program Tags: Thrombolysis Clinical Sciences Source Type: research

Different Doses of Recombinant Tissue-Type Plasminogen Activator for Acute Stroke in Chinese Patients Clinical Sciences
Conclusions— These results did not support the dose of 0.9 mg/kg of r-tPA being optimal for all patients in the East Asian population. In elderly patients (71–80 years), a lower dose of 0.6 mg/kg is associated with a better outcome. Confirmation of the results through randomized trial is required.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Chao, A.-C., Liu, C.-K., Chen, C.-H., Lin, H.-J., Liu, C.-H., Jeng, J.-S., Hu, C.-J., Chung, C.-P., Hsu, H.-Y., Sheng, W.-Y., Hu, H.-H., on behalf of the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) Study Group Tags: Thrombolysis Clinical Sciences Source Type: research

Strategic Planning to Reduce the Burden of Stroke Among Veterans: Using Simulation Modeling to Inform Decision Making Clinical Sciences
Conclusions— Prevention strategies tend to have larger population impacts, though interventions targeting specific high-risk groups tend to be more efficient in terms of number-needed-to-treat per QALY gained.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Lich, K. H., Tian, Y., Beadles, C. A., Williams, L. S., Bravata, D. M., Cheng, E. M., Bosworth, H. B., Homer, J. B., Matchar, D. B. Tags: Health policy and outcome research Clinical Sciences Source Type: research

Emergence of the Primary Pediatric Stroke Center: Impact of the Thrombolysis in Pediatric Stroke Trial Clinical Sciences
Conclusions— Before preparing for TIPS, centers interested in pediatric stroke had not developed systematic strategies to diagnose and treat acute pediatric stroke. TIPS trial preparation has resulted in establishment of pediatric acute stroke centers with clinical and system preparedness for evaluation and care of children with acute stroke, including use of a standardized protocol for evaluation and treatment of acute arterial stroke in children that includes use of intravenous tissue-type plasminogen activator. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01591096.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Bernard, T. J., Rivkin, M. J., Scholz, K., deVeber, G., Kirton, A., Gill, J. C., Chan, A. K., Hovinga, C. A., Ichord, R. N., Grotta, J. C., Jordan, L. C., Benedict, S., Friedman, N. R., Dowling, M. M., Elbers, J., Torres, M., Sultan, S., Cummings, D. D., Tags: Fibrinolysis, Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Totaled Health Risks in Vascular Events Score Predicts Clinical Outcomes in Patients With Cardioembolic and Other Subtypes of Ischemic Stroke Clinical Sciences
Conclusions— The THRIVE score is a simple tool that helps clinicians estimate good outcome and death after ischemic stroke.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Lei, C., Wu, B., Liu, M., Chen, Y., Yang, H., Wang, D., Lin, S., Hao, Z. Tags: Acute Cerebral Infarction Clinical Sciences Source Type: research

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