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Safety outcomes of early initiation of antithrombotic agents within 24  h after intravenous alteplase at 0.6 mg/kg
We examined outcome of acute ischemic stroke (AIS) with administration of antithrombotics within 24  h after intravenous low-dose alteplase.
Source: Journal of the Neurological Sciences - January 6, 2023 Category: Neurology Authors: Tetsuya Chiba, Takeshi Yoshimoto, Shinichi Wada, Masayuki Shiozawa, Sohei Yoshimura, Shunsuke Kimura, Manabu Inoue, Kazunori Toyoda, Masafumi Ihara, Masatoshi Koga Source Type: research

Safety outcomes of early initiation of antithrombotic agents within 24  h after intravenous alteplase at 0.6 mg/kg
We examined outcome of acute ischemic stroke (AIS) with administration of antithrombotics within 24  h after intravenous low-dose alteplase.
Source: Journal of the Neurological Sciences - January 6, 2023 Category: Neurology Authors: Tetsuya Chiba, Takeshi Yoshimoto, Shinichi Wada, Masayuki Shiozawa, Sohei Yoshimura, Shunsuke Kimura, Manabu Inoue, Kazunori Toyoda, Masafumi Ihara, Masatoshi Koga Source Type: research

Comparative efficacy and safety of tenecteplase and alteplase in acute ischemic stroke: A pairwise and network meta-analysis of randomized controlled trials
Studies on tenecteplase have been yielding mixed results on several important variables at different doses, thus hampering objective guideline recommendations in acute ischemic stroke management. This meta-analysis stratifies doses in order to refine our interpretation of outcomes and quantify the benefits and harms of tenecteplase at different doses.
Source: Journal of the Neurological Sciences - December 28, 2022 Category: Neurology Authors: Aqeeb Ur Rehman, Aleenah Mohsin, Huzaifa Ahmad Cheema, Afra Zahid, Muhammad Ebaad Ur Rehman, Muhammad Zain Ameer, Muhammad Ayyan, Muhammad Ehsan, Abia Shahid, Muhammad Aemaz Ur Rehman, Jaffer Shah, Ayaz Khawaja Tags: Review Article Source Type: research

Low-dose versus standard-dose intravenous alteplase for octogenerian acute ischemic stroke patients: A multicenter prospective cohort study
The optimal dose of alteplase for acute ischemic stroke among geriatric patients is unclear. We aimed to assess the efficacy and safety of a low-dose (0.6  mg/kg) and standard-dose (0.9 mg/kg) alteplase for varying severity of Asian geriatric stroke patients.
Source: Journal of the Neurological Sciences - January 29, 2019 Category: Neurology Authors: A-Ching Chao, Ke Han, Sheng-Feng Lin, Ruey-Tay Lin, Chih-Hung Chen, Lung Chan, Huey-Juan Lin, Yu Sun, Yung-Yang Lin, Po-Lin Chen, Shinn-Kuang Lin, Cheng-Yu Wei, Yu-Te Lin, Jiunn-Tay Lee, Han-Hwa Hu, Chyi-Huey Bai, On behalf of the Taiwan Thrombolytic Ther Source Type: research

Intravenous thrombolysis in stroke patients taking novel oral anticoagulants: experience with the low-dose 0.6  mg/kg of recombinant tissue-type plasminogen activator. Case reports
In the last decade, the novel oral anticoagulant (NOAC) dabigatran (a direct thrombin inhibitor), rivaroxaban, apixaban and edoxaban (direct factor Xa inhibitors) have been approved for primary and secondary prevention of stroke in patients with atrial fibrillation (AF) [1]. Compared with vitamin k antagonists such as warfarin, the NOACs offer benefits in terms of efficacy, safety and convenience [2]. The only currently approved treatment for acute stroke with a class I recommendation and level A evidence is intravenous recombinant tissue-type plasminogen activator alteplase (IV rt-PA) [4].
Source: Journal of the Neurological Sciences - July 7, 2018 Category: Neurology Authors: Massimiliano Plastino, Domenico Bosco, Laura Giofr è, Dario Cristiano, Franco Galati, Paolo Postorino, Arturo Consoli, Antonietta Fava, Domenico Consoli Tags: Letter to the Editor Source Type: research

Comparative effects of low-dose versus standard-dose alteplase in ischemic patients with prior stroke and/or diabetes mellitus: The ENCHANTED trial
History of prior stroke (PS) and diabetes mellitus (DM) are considered relative contraindications to the use of intravenous alteplase in patients with acute ischemic stroke (AIS). We aimed to assess whether a history of PS and DM modified the comparative effects of low- versus standard-dose alteplase in patients who participated in the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).
Source: Journal of the Neurological Sciences - January 11, 2018 Category: Neurology Authors: Guofang Chen, Xia Wang, Thompson G. Robinson, Richard I. Lindley, Shengkui Zhou, Lei Ping, Weiwei Liu, Leijing Liu, John Chalmers, Craig S. Anderson, for the ENCHANTED Investigators Source Type: research

Safety and preliminary efficacy of intravenous tirofiban in acute ischemic stroke patient without arterial occlusion on neurovascular imaging studies
In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study.
Source: Journal of the Neurological Sciences - October 26, 2017 Category: Neurology Authors: Lu Lin, Wei Li, Cheng-Chun Liu, Ya Wu, Shu-Han Huang, Xiao-Shu Li, Chun-Rong Liang, Huan Wang, Li-Li Zhang, Zhi-Qiang Xu, Yan-Jiang Wang, Wuwei Feng, Meng Zhang Source Type: research

Orolingual angioedema after thrombolysis is not associated with insular cortex ischemia on pre-thrombolysis CT
Objective: Orolingual angioedema (OA) is a well known early complication of treatment with alteplase in ischemic stroke patients. Our aim was to study risk factors for OA in these patients, namely insular cortex ischemia.Methods: Retrospective case-cohort study using the prospective registry of all consecutive ischemic stroke patients submitted to intravenous thrombolysis with alteplase. Clinical data was retrieved from the registry and medical records. Two independent observers evaluated early signs of insular cortex ischemia on pre-thrombolysis computed tomography (CT) and of insular cortex infarct on early follow-up imaging.
Source: Journal of the Neurological Sciences - July 18, 2016 Category: Neurology Authors: Jo ão Pinho, José Nuno Alves, Liliana Oliveira, Sara Pereira, Joana Barros, Célia Machado, José Manuel Amorim, Ana Filipa Santos, Manuel Ribeiro, Carla Ferreira Source Type: research

Intravenous Alteplase for acute ischemic stroke in patients with current malignant neoplasm
Conclusions: Our experience suggests that IV thrombolysis does not appear to increase the risk of hemorrhagic complications in current non-metastatic cancer patients in absence of additional risk factors of bleeding. In addition, these patients showed clinical improvement after IV thrombolysis, although replication of our findings in a randomized controlled trial is required to confirm our results.
Source: Journal of the Neurological Sciences - January 14, 2013 Category: Neurology Authors: Manuel Cappellari, Monica Carletti, Nicola Micheletti, Giampaolo Tomelleri, Domenico Ajena, Giuseppe Moretto, Paolo Bovi Tags: Original Articles Source Type: research