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Intravenous thrombolysis is more safe and effective for posterior circulation stroke: Data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
Abstract: We aimed to compare the safety and efficacy of intravenous thrombolysis (IVT) with alteplase for anterior circulation stroke (ACS) and posterior circulation stroke (PCS). From a large multicenter prospective registry—the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database—all patients who received IVT within 4.5 hours after stroke onset was reviewed. According to the clinical presentations and imaging findings, the eligible patients were divided into ACS and PCS groups. The safety and efficacy outcome measures included post-IVT symptomatic intracranial hemorrhage (sICH), paren...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Cardiovascular Instability Preceded by Orolingual Angioedema after Alteplase Treatment.
Authors: Kageyama T, Okanoue Y, Takai R, Suenaga T Abstract An 87-year-old man taking antihypertensive medications, including 10 mg enalapril, daily visited our hospital complaining of motor aphasia, dysarthria, and right hemiparesis. Magnetic resonance imaging revealed an ischemic lesion in the left frontal lobe including the insular cortex and severe stenosis of the left middle cerebral artery. After he received intravenous alteplase infusion, he developed orolingual angioedema followed by transient bradycardia with subsequent hypotension, resulting in the deterioration of his neurological signs and expansion of ...
Source: Internal Medicine - February 17, 2016 Category: Internal Medicine Tags: Intern Med Source Type: research

Timing of thrombolysis for acute ischaemic stroke: the earlier the treatment the better the outcome, irrespective of age or stroke severity
This study looked at how treatment delay, patient age and stroke severity influence the effect of t-PA in AIS in terms of functional outcome, mortality and intracranial haemorrhage (ICH). Methods This was a preplanned meta-analysis of individual patient data from nine randomised clinical trials of intravenous alteplase for AIS. The primary efficacy measure was the proportion of patients who achieved a 3–6 month...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Lorenzano, S. Tags: Epidemiologic studies, Stroke, Radiology, Clinical diagnostic tests Therapeutics/Prevention Source Type: research

Pooled RCTs: Alteplase within 4.5 hours of ischemic stroke improves the likelihood of good outcome.
PMID: 25599363 [PubMed - in process]
Source: Annals of Internal Medicine - January 20, 2015 Category: Internal Medicine Authors: Uchino K Tags: Ann Intern Med Source Type: research

Assessment of point‐of‐care measurement of international normalised ratio using the CoaguChek XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint‐of‐care INR testing correlates well with laboratory values. The results in this study mostly relate to values in the normal range. We suggest that it can be used to try to shorten door‐to‐needle time.
Source: Internal Medicine Journal - November 15, 2013 Category: Internal Medicine Authors: D. Nusa, I. Harvey, A. Y. Almansouri, S. Wright, T. Neeman, O Ahmad, A. R. Hughes, C. J. Lueck Tags: Original Article Source Type: research

An assessment of point‐of‐care measurement of INR using the Coaguchek®XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint of care INR testing correlates well with laboratory values. The results in this study mostly relate to levels in the normal range. We suggest that it can be appropriately used to shorten door‐to‐needle time.
Source: Internal Medicine Journal - July 30, 2013 Category: Internal Medicine Authors: Dawn Nusa, Isabel Harvey, Abdulrahman Y Almansouri, Simogne Wright, Terry Neeman, Omar Ahmad, Andrew R. Hughes, Christian J. Lueck Tags: Original Article Source Type: research

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