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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

Smoking-Thrombolysis Paradox: Recanalization and Reperfusion Rates After Intravenous Tissue Plasminogen Activator in Smokers With Ischemic Stroke Original Contributions
Conclusions— Smoking is independently associated with recanalization and reperfusion, indicating that thrombolytic therapy acts more effectively in smokers; because of small numbers, these results should be considered preliminary. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique Identifier: NCT00715533.
Source: Stroke - January 18, 2013 Category: Neurology Authors: Kufner, A., Nolte, C. H., Galinovic, I., Brunecker, P., Kufner, G. M., Endres, M., Fiebach, J. B., Ebinger, M. Tags: Fibrinolysis, Angiography, Computerized tomography and Magnetic Resonance Imaging, Risk Factors for Stroke, Thrombolysis Original Contributions Source Type: research

Predictors of in‐hospital death and symptomatic intracranial hemorrhage in patients with acute ischemic stroke treated with thrombolytic therapy: Paul Coverdell Acute Stroke Registry 2008–2012
ConclusionsIn this study of acute ischemic stroke patients, older age, male gender, National Institutes of Health Stroke Scale score, history of myocardial infarction or coronary artery disease, and history of atrial fibrillation were associated with increased in‐hospital death among patients receiving intravenous tissue plasminogen activator. Among patients treated with intravenous tissue plasminogen activator, in‐hospital mortality and symptomatic intracerebral hemorrhage rates were similar between those treated within three‐hours of time last known to be well and those treated between three and 4·5 hours after this time.
Source: International Journal of Stroke - September 12, 2013 Category: Neurology Authors: Xin Tong, Mary G. George, Quanhe Yang, Cathleen Gillespie Tags: Research 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

National data on stroke outcomes in Thailand
In conclusion, the prevalence and outcomes of stroke in Thailand were comparable with other countries. The era of thrombolytic therapy has just begun in Thailand.
Source: Journal of Clinical Neuroscience - January 14, 2015 Category: Neuroscience Source Type: research

Ischemic stroke complicating thrombolytic therapy with tenecteplase for ST elevation myocardial infarction: two case reports
ConclusionsHemorrhagic stroke is not the only complication of thrombolysis, ischemic stroke can occur even if it is an extremely rare complication. The two cases on which we report shed light on the association between fibrinolytic therapy and ischemic stroke, the pathophysiology of which is not well understood.
Source: Journal of Medical Case Reports - June 11, 2017 Category: General Medicine Source Type: research

Rescue thrombolysis in the treatment of cardiac shock and acute stroke
The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ...
Source: The American Journal of Emergency Medicine - April 19, 2013 Category: Emergency Medicine Authors: Sukru Akyuz, Mustafa Azmi Sungur, Cevdet Donmez, Aylin Sungur, Nese Cam Tags: Case Reports Source Type: research

Emergent Angioplasty and Stent Placement Recanalization Without Thrombolysis in Acute Middle Cerebral Artery Occlusions
This study evaluated the feasibility, efficacy, and safety of intracranial artery recanalization for acute middle cerebral artery (MCA) occlusion using emergent angioplasty and stent placement without thrombolysis. All patients from a retrospectively collected database who met the inclusion criteria and were treated with an intracranial stent for acute MCA occlusion were included. Treatment comprised angioplasty and stenting without interventional thrombolytic therapy. Recanalization was assessed by angiography immediately after stent placement based on the Thrombolysis in Myocardial Infarction (TIMI) score. Complications ...
Source: Journal of Stroke and Cerebrovascular Diseases - December 12, 2011 Category: Neurology Authors: Xin-Bin Guo, Lai-Jun Song, Sheng Guan Tags: Original Articles Source Type: research

Endothelial markers are associated with thrombolysis resistance in acute stroke patients
ConclusionsRecanalization after thrombolytic therapy is associated with low sTM and sEPCR levels but not with vWF levels. If corroborated in further larger studies, these findings could be helpful in the identification of patients resistant to rt‐PA thrombolysis who could benefit from a modified recanalization therapy.
Source: European Journal of Neurology - February 4, 2014 Category: Neurology Authors: D. Faille, J. Labreuche, E. Meseguer, M.‐G. Huisse, N. Ajzenberg, M. Mazighi Tags: Original Article Source Type: research

Thrombolytic therapy-associated acute myocardial infarction in patients with acute ischemic stroke: A treatment dilemma
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events.
Source: The American Journal of Emergency Medicine - November 21, 2016 Category: Emergency Medicine Authors: Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai Source Type: research

Early ST-segment elevation acute myocardial infarction after thrombolytic therapy for acute ischemic stroke: A case report
We report a case of STEMI occurring 40 minutes after thrombolytic therapy for AIS and discuss the possible mechanisms and therapeutic approaches. Patient concerns: A 87-year-old woman with a history of arterial hypertension was admitted for acute onset of right-sided limb weakness 2 hours before arrival at the emergency department. Forty minutes after intravenous recombinant tissue plasminogen activator (i.v. rtPA) administration for AIS, STEMI occurred (signaled by a third-degree atrioventricular block). Diagnoses: The diagnoses were AIS and STEMI. Coronary angiography confirmed right coronary artery occlusion. ...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke
We present a rare case of coexisting thrombosis of the coronary artery and mid cerebral artery that was managed successfully with tissue plasminogen activator thrombolytic therapy.
Source: The American Journal of Emergency Medicine - December 31, 2018 Category: Emergency Medicine Authors: Fatih Gungoren, Feyzullah Besli, Zulkif Tanriverdi, Ozcan Kocaturk Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Nationwide Experience of Cardio- and Cerebrovascular Complications During Infrainguinal Endovascular Intervention for Peripheral Arterial Disease and Acute Limb Ischaemia.
CONCLUSIONS: In this population-based study we found a low risk of cardiac complications, but catheter-administered thrombolytic therapy entailed a non-negligible risk of major stroke. PMID: 23333098 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - January 17, 2013 Category: Surgery Authors: Nordanstig J, Smidfelt K, Langenskiöld M, Kragsterman B Tags: Eur J Vasc Endovasc Surg Source Type: research

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