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M2 segment thrombectomy is not associated with increased complication risk compared to M1 segment: A meta-analysis of recent literature
Numerous trials report safety and efficacy of mechanical thrombectomy (MT) for infarcts involving the M1 segment of the middle cerebral artery (MCA; extending from the terminal bifurcation of the internal carotid artery proximally to the main bifurcation distally) in comparison to intravenous thrombolytic therapy (e.g. alteplase) therapy alone.1 –5 The Highly Effective Reperfusion Using Multiple Endovascular Devices (HERMES) meta-analysis of these early studies reported a number needed to treat of 2.6 for MT to reduce the modified Rankin Scale (mRS) by 1 point.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Christopher Alexander, Andrew Caras, William Kyle Miller, Rizwan Tahir, Tarek R. Mansour, Azedine Medhkour, Horia Marin Source Type: research

Safety and Efficacy of Intravenous Thrombolytic Therapy in Patients With Acute Posterior Circulation Stroke: A Single-Center Study
This study was designed to evaluate the prestroke and baseline characteristics, stroke sub-types, complications, and outcomes of PCS patients and compare them with anterior circulation stroke (ACS) after intravenous thrombolysis. Methods: Data of consecutive patients with PCS and ACS treated with alteplase in a standard dose of 0.9 mg/kg in our stroke center were collected and analyzed retrospectively.
Source: Journal of Stroke and Cerebrovascular Diseases - December 1, 2019 Category: Neurology Authors: Xuan Zhu, Nuo Wang, Huangbin Lin, Ping Zhang, Lei Chen, Minmin Zhang, Benqiang Deng, Tao Wu Source Type: research

Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke
We report a single-center, retrospective assessment of the safety and efficacy of alteplase treatment within 45 minutes. Methods: Five hundred and eighty-six patients were treated with alteplase in our emergency departments (EDs) between January 2014 and October 2016; 368 patients were included for analysis.
Source: Journal of Stroke and Cerebrovascular Diseases - October 9, 2019 Category: Neurology Authors: Sarah Jung, Jamie M. Rosini, Jason T. Nomura, Richard J. Caplan, Jonathan Raser-Schramm Source Type: research

Symptomatic Intracerebral Hemorrhage after Intravenous Thrombolysis: Predictive Factors and Validation of Prediction Models
Objective: Thrombolytic therapy with intravenous alteplase (IV-rtPA) has a known risk of symptomatic intracerebral hemorrhage (sICH). We aim to identify factors with a significant association with the development of sICH post-IV-rtPA. We also aim to perform an external validation of sICH predicting scores in our patient population. Material and Methods: We performed a retrospective chart review of patients who received IV-rtPA at our tertiary care hospital. We excluded patients who underwent mechanical thrombectomy.
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Taha Nisar, Rajanigandhi Hanumanthu, Priyank Khandelwal Source Type: research

Efficacy of Tirofiban Administered at Different Time Points after Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Ischemic Stroke
To evaluate the efficacy of tirofiban administered at different time points within 24 hours of intravenous thrombolysis with alteplase in acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - January 14, 2019 Category: Neurology Authors: Jin Liu, Qiuyan Shi, Yuan Sun, Jingyuan He, Bin Yang, Chunyang Zhang, Rui Guo Source Type: research

Thrombolytic Therapy of Acute Ischemic Stroke during Early Pregnancy
Thrombolytic treatment (recombinant tissue plasminogen activator [rt-PA]) has established efficacy in acute ischemic stroke, but pregnancy has been an exclusion criterion for all clinical trials that validated alteplase in acute stroke, so our knowledge about its use in this condition is limited.Herein we report the successful use of intravenous rt-PA thrombolysis, uncomplicated by neither hemorrhage development nor other complication in a woman who was 13 weeks pregnant with acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 28, 2017 Category: Neurology Authors: Anne Landais, Hugo Chaumont, Rachel Dellis Tags: Case Studies Source Type: research

Thrombolysis for Ischemic Stroke during Pregnancy: A Case Report and Review of the Literature
We report the successful use of intravenous alteplase (tissue plasminogen activator; tPA) thrombolysis in a pregnant woman with acute cardioembolic stroke presumed to be paradoxical embolism through a patent foramen ovale.
Source: Journal of Stroke and Cerebrovascular Diseases - August 10, 2016 Category: Neurology Authors: Steven Tversky, Richard B. Libman, Marina L. Reppucci, Andrea M. Tufano, Jeffrey M. Katz Tags: Case Studies Source Type: research

Fatal Intracranial Hemorrhage after Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Associated with Cancer-related Nonbacterial Thrombotic Endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is associated with hypercoagulability in patients with inflammatory states such as cancer and autoimmune diseases. Cardiac vegetations caused by NBTE often lead to life-threatening systemic thromboembolism that most frequently affects the brain, spleen, and kidneys. A 54-year-old woman diagnosed with ovarian cancer suddenly developed back pain and left hemiparesis. Although intravenous alteplase (rt-PA) therapy was administered to treat hyperacute ischemic infarction detected by magnetic resonance imaging, intracranial hemorrhage occurred in the left hemisphere several hours late...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Takuya Yagi, Kie Takahashi, Mariko Tanikawa, Morinobu Seki, Takato Abe, Norihiro Suzuki Tags: Case Reports Source Type: research