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Condition: Bleeding
Therapy: Thrombolytic Therapy

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Total 159 results found since Jan 2013.

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

Low Levels of Caveolin-1 Predict Symptomatic Bleeding After Thrombolytic Therapy in Patients With Acute Ischemic Stroke Brief Report
Background and Purpose—Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke.Methods—We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4.5 hours of symptom onset. HT was evaluated and classified on cranial computed t...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kadar, Gemma Huguet, Josep Puig, Tomas Sobrino, Gerard Blasco, Joaquin Serena, Juan Manuel Sanchez Tags: Biomarkers, Endothelium/Vascular Type/Nitric Oxide, Blood-Brain Barrier, Ischemic Stroke Brief Reports Source Type: research

Neurogenesis in Stroke Recovery
Abstract Stroke, resulting from limited blood flow to the brain, is one of the most important causes of morbidity and mortality worldwide. Stroke is classified as ischemic, due to lack of blood flow, or hemorrhagic, due to bleeding. Because 87 % of strokes are classified as ischemic, this type will be the predominant focus of this review. Except for thrombolytic therapy, there is no established treatment to reduce the neurological deficits caused by ischemic stroke. Therefore, it is necessary to develop new therapeutic strategies designed to improve neurological functions after ischemic stroke. Recently, therapie...
Source: Translational Stroke Research - March 17, 2016 Category: Neurology Source Type: research

Why Ischemic Stroke Patients Do Not Receive Thrombolytic Treatment? (P7.122)
CONCLUSIONS:This retrospective analysis suggests that less than half of the patients presenting within 4 hours of symptom onset receive rt-PA. The most common reason was minor or rapidly improving symptoms. A significant proportion of patients did not receive rt-PA because patient or family refused. Minority of patients had absolute contraindication. More patient and family education is needed to allay fears of rt-PA use.Disclosure: Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lahoti, S., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Original Articles
Conclusions— Presence of CKD among patients with IS treated with intravenous tissue-type plasminogen activator is associated with higher unadjusted odds of symptomatic intracranial hemorrhage or serious systemic hemorrhage, but this is explained by non-CKD related factors.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Ovbiagele, B., Smith, E. E., Schwamm, L. H., Grau-Sepulveda, M. V., Saver, J. L., Bhatt, D. L., Hernandez, A. F., Peterson, E. D., Fonarow, G. C. Tags: Cerebrovascular disease/stroke, Risk Factors, Acute Cerebral Infarction, Thrombolysis Original Articles Source Type: research

Intravenous Thrombolysis in Anticoagulated and Thrombocytopenic Ischemic Stroke Patients Does Not Increase the Risk of Intracerebral Hemorrhage (P4.271)
Conclusions:These data suggest that IV rt-PA can be safely administered in coagulopathic and thrombocytopenic patients. Although rates of sICH and mortality were similar to the NINDS cohort, caution may be needed to identify certain hemorrhagic risk factors. Routine exclusion of anticoagulated or thrombocytopenic patients is not supported and the use of IV rt-PA in these patients may increase the eligibility for acute stroke therapy, particularly at institutions where IA therapy is unavailable.Disclosure: Dr. Barazangi has received personal compensation for activities with Genentech. Dr. Sorensen has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Barazangi, N., Sorensen, S., Chen, C., Wong, C., Yee, A., Ke, M., Rose, J., Grosvenor, D., Bedenk, A., Fernandes, J., Tong, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Thrombolysis for acute ischaemic stroke.
CONCLUSIONS: Thrombolytic therapy given up to six hours after stroke reduces the proportion of dead or dependent people. Those treated within the first three hours derive substantially more benefit than with later treatment. This overall benefit was apparent despite an increase in symptomatic intracranial haemorrhage, deaths at seven to 10 days, and deaths at final follow-up (except for trials testing rt-PA, which had no effect on death at final follow-up). Further trials are needed to identify the latest time window, whether people with mild stroke benefit from thrombolysis, to find ways of reducing symptomatic intracrani...
Source: Cochrane Database of Systematic Reviews - August 3, 2014 Category: Journals (General) Authors: Wardlaw JM, Murray V, Berge E, Del Zoppo GJ Tags: Cochrane Database Syst Rev Source Type: research

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Patient Factors Do Not Predict Thrombolysis in Stroke Mimics (P6.031)
CONCLUSIONS: Physician decision to administer thrombolysis in stroke mimic patients without clear contraindication is not associated with patient demographic or clinical factors. Our study is limited by its retrospective nature and small sample size, however continued data collection is in process.Disclosure: Dr. Gildersleeve has nothing to disclose. Dr. Pandurengan has nothing to disclose. Dr. Gonzales has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Gildersleeve, K., Pandurengan, R., Gonzales, N. Tags: Neurotherapeutics Source Type: research

Intravenous Recombinant Tissue Plasminogen Activator Therapy for Acute Basilar Artery Ischemic Stroke Following Transfemoral Transcatheter Aortic Valve Implantation.
Authors: Montarello NJ, Nelson AJ, Sidharta SL, Worthley SG Abstract Transcatheter aortic valve implantation (TAVI) can now be considered a standard of care for inoperable and high-risk surgical patients with severe aortic stenosis, and its uptake worldwide is rapidly increasing. Indeed, many centers performing the procedure have now moved towards treating intermediate-risk patients with TAVI rather than referring them for surgical aortic valve replacement. Although the incidence of peri-procedural acute and subacute stroke following TAVI has fallen to 2-5%, its occurrence can be life-threatening and life-changing,...
Source: Journal of Heart Valve Disease - December 21, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

The importance of atrial fibrillation and selected echocardiographic parameters for the effectiveness and safety of thrombolytic therapy in patients with stroke
ConclusionsThe presence of atrial fibrillation worsens the patient's prognosis in terms of the functional status and survival during the acute period of stroke in patients treated with intravenous thrombolysis.Higher NIHSS and CHA2DS2VASc scores and reduced EF in patients with stroke treated with thrombolysis are the predictors of unfavorable short-term prognosis.
Source: Polish Journal of Neurology and Neurosurgery - July 6, 2018 Category: Neurosurgery Source Type: research