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Specialty: Hematology
Source: Journal of Thrombosis and Thrombolysis
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Total 309 results found since Jan 2013.
The administration of rtPA before mechanical thrombectomy in acute ischemic stroke patients is associated with a significant reduction of the retrieved clot area but it does not influence revascularization outcome
AbstractBoth intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatments for acute ischemic stroke (AIS) in selected cases. Recanalization may occur following IVT without the necessity of further interventions or requiring a subsequent MT procedure. IVT prior to MT (bridging-therapy) may be associated with benefits or hazards. We studied the retrieved clot area and degree of recanalization in patients undergoing MT or bridging-therapy for whom it was possible to collect thrombus material. We collected mechanically extracted thrombi from 550 AIS patients from four International stroke cente...
Source: Journal of Thrombosis and Thrombolysis - September 15, 2020 Category: Hematology Source Type: research
Safety of intravenous thrombolysis in stroke of unknown time of onset: A systematic review and meta-analysis
AbstractThe safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke of unknown time of onset (SUTO) was unclear and mostly concerned. We sought to investigate the safety in terms of symptomatic intracranial hemorrhage (sICH) and death in SUTO patients treated with IV-tPA. We searched PubMed and EMBASE from inception to 2 December 2020 for eligible studies reporting IV-tPA in SUTO patients compared to conservative medical therapy, or to stroke of known onset time (SKOT) treated with IV-tPA within standard time window. We pooled relative risk (RR) with 95% confidence interval (95%CI) with random-e...
Source: Journal of Thrombosis and Thrombolysis - May 7, 2021 Category: Hematology Source Type: research
Thrombectomy for ischemic stroke with large vessel occlusion and concomitant subarachnoid hemorrhage
AbstractTo report our experience in treating one patient with nontraumatic subarachnoid hemorrhage (SAH) and concurrent acute ischemic stroke (AIS) due to large vessels occlusion (LVO). A man in his 50 s presented with acute right hemiparesis and aphasia. Brain CT showed a SAH in the left central sulcus; CT-angiography revealed a tandem occlusion of the left internal carotid artery and homolateral middle cerebral artery. He underwent an angiographic procedure with successful recanalization. Foll ow-up CT demonstrated a striatal-lenticular stroke without SAH progression. While the absolute contraindication to IVT during i...
Source: Journal of Thrombosis and Thrombolysis - June 8, 2021 Category: Hematology Source Type: research
The clot thickens —enhanced integration of stroke and thrombosis training
AbstractThere is significant overlap between knowledge and its clinical application in stroke and thrombosis& vascular medicine. Formal integration of training is, however, not standard. After the hyperacute phase of management, personalized medical decisions are often needed regarding antithrombotics and anticoagulants that leverage clinical practice parameters from both disciplines with a unique emphasis on minimizing neurologic treatment complications. We completed an ad hoc survey of adult thrombosis fellowships at several North American centers. We discovered that direct integration of training programs is not pre...
Source: Journal of Thrombosis and Thrombolysis - July 7, 2021 Category: Hematology Source Type: research
Efficacy outcomes and safety measures of intravenous tirofiban or eptifibatide for patients with acute ischemic stroke: a systematic review and meta-analysis of prospective studies
AbstractTo review the literature for randomized control trials (RCTs) and prospective cohort studies investigating the safety and efficacy of tirofiban and eptifibatide in patients with acute ischemic stroke (AIS). PubMed, Embase, and the Cochrane library were searched for available papers published up to September 2021. The efficacy was evaluated based on the 3-month favorable outcome [modified Rankin scale (mRS) = 0–1], functional outcome (mRS = 0–2), and the last available National Institutes of Health Stroke Scale (NIHSS) score measured in each study. Twelve studies (two RCTs and 10 prospective cohorts) an...
Source: Journal of Thrombosis and Thrombolysis - November 15, 2021 Category: Hematology Source Type: research
Comparison of early and delayed anticoagulation therapy after ischemic stroke in patients with atrial fibrillation: a systematic review and meta-analysis
AbstractThe optimal initiation timing of oral anticoagulants (OACs) remains controversial in patients with atrial fibrillation (AF)-related acute ischemic stroke (AIS). The aim of this study is to compare the efficacy and safety of early OACs initiation with that of the delayed initiation for AIS and AF.We searched systematically the following mainstream databases: PubMed, Embase, and Web of Science from the inception to July 2023 for studies that compared the early initiation with the delayed initiation of OACs for AF-related AIS patients. Outcome measures were the incidence of hemorrhagic events, ischemic events, and com...
Source: Journal of Thrombosis and Thrombolysis - July 28, 2023 Category: Hematology Source Type: research
Direct penetrating and indirect neck trauma as a cause of internal carotid artery thrombosis and secondary ischemic stroke
Abstract
The following manuscript presents two cases of ischemic stroke secondary to traumatic internal carotid artery thrombosis with concomitant middle cerebral artery thrombosis occurring very rarely in the medico-legal practice. Penetrating neck trauma due to an occupational accident and multiple head and neck trauma secondary to battery were described. The autopsy and histopathological examination as well as the analysis of available medical records, including radiological examinations, and records of investigation indicated the sustained trauma to be the cause of the thrombosis.
Source: Journal of Thrombosis and Thrombolysis - September 25, 2014 Category: Hematology Source Type: research
Association between NINJ2 gene polymorphisms and ischemic stroke: a family-based case–control study
Abstract
Novel susceptibility genes related to ischemic stroke (IS) are proposed in recent literatures. Population-based replicate studies would cause false positive results due to population stratification. 229 recruit IS patients and their 229 non-IS siblings were used in this study to avoid population stratification. The family-based study was conducted in Beijing from June 2005 to June 2012. Association between SNPs and IS was found in the sibship discordant tests, and the conditional logistic regression was performed to identify effect size and explore gene–environment interactions. Significant allelic ass...
Source: Journal of Thrombosis and Thrombolysis - October 2, 2014 Category: Hematology Source Type: research
Thrombelastography does not predict clinical response to rtPA for acute ischemic stroke
Abstract
Thrombelastography (TEG) measures coagulation in venous blood. We hypothesized that TEG, by reflecting clot subtype and ex vivo fibrinolysis, might predict fibrinolytic response to tPA as reflected by rapid clinical improvement or hemorrhagic transformation of the infarct. 171 acute ischemic stroke patients treated with tPA were prospectively enrolled. Venous blood for TEG was drawn before and 10 min after tPA bolus. We measured rapid clinical improvement (RCI = 8 point improvement on NIHSS or total NIHSS of 0, 1 at 36 h), Hemorrhagic transformation (HT = any blood on imaging within 36 h), and hyp...
Source: Journal of Thrombosis and Thrombolysis - March 23, 2016 Category: Hematology Source Type: research
Activation of blood coagulation and thrombin generation in acute ischemic stroke treated with rtPA
AbstractThe impact of thrombolysis with recombinant tissue plasminogen activator (rtPA) on blood coagulation in acute ischemic stroke (AIS) patients is not completely understood. We studied the effect of thrombolysis on the thrombin generation (TG) profile as well as coagulant activity of activated factors IX (FIXa), XI (FXIa) and tissue factor (TF) in AIS patients. In a case-control study, TG parameters as well as FIXa, FXIa and TF levels were assessed in 95 AIS patients, including individuals receiving rtPA treatment within 4.5 h since AIS onset (n = 71, 74.7%) and those ineligible for thrombolysis (n = 24, 25....
Source: Journal of Thrombosis and Thrombolysis - September 6, 2017 Category: Hematology Source Type: research
Influence of cytochrome P450 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke previously treated with clopidogrel
AbstractThis randomized double-blind crossover study aimed to investigate the influence of cytochrome P450 (CYP) 2C19 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke treated with clopidogrel. Patients received clopidogrel 75 mg/day for> 4 weeks. Subsequently, patients received prasugrel 3.75 mg/day (group A;n = 64) or 2.5 mg/day (group B;n = 65) for 4 weeks followed by a 4 week switched-dose regimen. To assess the influence of CYP2C19 polymorphisms, patients were classified as extensive metabolizers (EMs), intermediate metabolizers (IMs), and poor metabo...
Source: Journal of Thrombosis and Thrombolysis - August 3, 2018 Category: Hematology Source Type: research
Does the administration of sonothrombolysis along with tissue plasminogen activator improve outcomes in acute ischemic stroke? A systematic review and meta-analysis
AbstractThis meta-analysis was conducted to assess the safety and efficacy of sonothrombolysis along with intravenous recombinant tissue plasminogen activator, alteplase (IV rtPA), in the management of acute ischemic stroke. Electronic databases were searched under different meSH terms without the restriction of time and language. 1415 studies were analyzed and seven studies that matched the inclusion criteria were selected. Multiple safety and efficacy outcomes were extracted. Our pooled analysis demonstrated that there is no significant difference between sonothrombolysis group and control group in preventing mortality (...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research
COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature
We report the pooled incidence of AIS in COVID-19 patients to be 1.2%, with a high mortality rate. Elevatedd-dimer, fibrinogen and the presence of antiphospholipid antibodies appear to be prominent in COVID-19 patients with concomitant AIS, but further mechanistic studies are required to elucidate their role in pathogenesis.
Source: Journal of Thrombosis and Thrombolysis - July 12, 2020 Category: Hematology Source Type: research
