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Therapy: Thrombolytic Therapy

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Total 183 results found since Jan 2013.

Quality of Acute Ischemic Stroke Care in Thailand: A Prospective Multicenter Countrywide Cohort Study
Conclusions: Limited access to acute ischemic stroke care interventions were observed in many domains especially thrombolysis and stroke unit admission. These findings emphasize an urgent need for strategies to improve standard acute stroke care among developing countries.
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2013 Category: Neurology Authors: Yongchai Nilanont, Samart Nidhinandana, Nijasri C. Suwanwela, Suchat Hanchaiphiboolkul, Taksin Pimpak, Pyatat Tatsanavivat, Gustavo Saposnik, Niphon Poungvarin, Thai Stroke Registry Tags: Original Articles Source Type: research

Intravenous Thrombolysis in Unknown-Onset Stroke Clinical Sciences
Conclusions—Our data suggest no excess risk of symptomatic intracerebral hemorrhage but increased mortality and reduced favorable outcome in patients with UKO stroke compared with patients treated within the approved time window.
Source: Stroke - February 26, 2017 Category: Neurology Authors: Laura Dorado, Niaz Ahmed, Gotz Thomalla, Manuel Lozano, Branko Maloȷcic, Mushtaq Wani, Monica Millan, Ales Tomek, Antoni Davalos Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Prognostic Significance of Short-Term Blood Pressure Variability in Acute Stroke: Systematic Review Clinical Sciences
Conclusions— This systematic review and meta-analysis suggest that greater systolic BPV, measured early from ischemic stroke or intracerebral hemorrhage onset, is associated with poor longer-term functional outcome. Future prospective studies should investigate how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Manning, L. S., Rothwell, P. M., Potter, J. F., Robinson, T. G. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Acute Stroke Syndromes Clinical Sciences Source Type: research

World Stroke Organization Global Stroke Services Guidelines and Action Plan
Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence‐based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions ...
Source: International Journal of Stroke - September 23, 2014 Category: Neurology Authors: Patrice Lindsay, Karen L. Furie, Stephen M. Davis, Geoffrey A. Donnan, Bo Norrving Tags: Guidelines Source Type: research

Effect of Alteplase Within 6 Hours of Acute Ischemic Stroke on All-Cause Mortality (Third International Stroke Trial) Clinical Sciences
Conclusions— These exploratory analyses of the third International Stroke Trial (IST-3) trial support improving acute stroke patients’ access to earlier alteplase treatment, treatment of patients with poor prognosis, and further randomized controlled trials in minor stroke to replicate these findings. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25765518.
Source: Stroke - November 24, 2014 Category: Neurology Authors: Whiteley, W. N., Thompson, D., Murray, G., Cohen, G., Lindley, R. I., Wardlaw, J., Sandercock, P., on behalf of the IST-3 Collaborative Group Tags: Acute Cerebral Infarction, Thrombolysis Clinical Sciences Source Type: research

Balancing access and quality in comprehensive stroke care
The establishment of stroke units and stroke centers has transformed the inpatient care of cerebrovascular disease and resulted in improved outcomes for patients hospitalized with stroke. Studies show that organized care as part of a stroke unit results in reduced mortality and disability after stroke,1 and that patients hospitalized at primary stroke centers have lower mortality and are more likely to receive thrombolytic therapy.2
Source: Neurology - March 23, 2015 Category: Neurology Authors: Kelly, A. G., Attia, J. Tags: All Health Services Research, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, All epidemiology EDITORIALS Source Type: research

Should minor stroke patients be thrombolyzed? A focused review and future directions
Stroke is a leading cause of morbidity and mortality worldwide. Up to 80% of ischemic stroke patients may initially present with minor symptoms. Minor stroke and transient ischemic attack patients are typically treated conservatively with antiplatelet agents and general vascular prevention strategies. Yet a high proportion develop recurrent stroke or progression of stroke and up to one in four of these patients are disabled or dead at follow‐up. Minor or rapidly improving symptoms are the top reasons for withholding thrombolytic therapy to time‐eligible stroke patients as they are believed to be ‘too good to treat’...
Source: International Journal of Stroke - December 25, 2014 Category: Neurology Authors: Amy Y. X. Yu, Michael D. Hill, Shelagh B. Coutts Tags: Review (invited) Source Type: research

Burden of stroke in Italy: An economic model highlights savings arising from reduced disability following thrombolysis
ConclusionOur study reveals that performing thrombolytic therapy in eligible patients improves economic outcomes compared with patients receiving standard care. This model is useful for decision makers, both within and outside of the Italian national context, as a tool to assess the cost‐effectiveness of thrombolysis in both short‐ and long‐term period.
Source: International Journal of Stroke - April 8, 2015 Category: Neurology Authors: M. Chiumente, M. M. Gianino, D. Minniti, T. J. Mattei, B. Spass, K. M. Kamal, D. E. Zimmerman, A. Muca, E. Luda Tags: Research Source Type: research

90 Day Outcome after Reperfusion Therapy of Stroke Patients with Baseline Disability: Unique Observations from Patients Treated on the Mobile Stroke Unit (P6.052)
Conclusion: In comparison to previously published data our analysis shows unfavorable outcome in the majority of patients with baseline disability who received thrombolytic therapy. The small sample size is a limitation to this analysis, and further studies are needed to assess if this subpopulation should be included in clinical trials assessing new therapies or modalities to deliver them.Disclosure: Dr. almaghrabi has nothing to disclose. Dr. Sarraj has nothing to disclose. Dr. Bowry has nothing to disclose. Dr. Parker has nothing to disclose. Dr. Yamal has nothing to disclose. Dr. Grotta has received personal compensati...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Almaghrabi, T., Sarraj, A., Bowry, R., Parker, S., Yamal, J.-M., Grotta, J. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research

Moving from traditional to more advanced treatments in stroke care is cost-effective: A case study from Greece
Ischemic stroke (IS) is one of the leading causes of mortality and disability,1, 2 with the economic burden of post-stroke care being substantial.1, 2 After incidence of IS, the following effective treatments have been found to significantly improve survival and quality of life: (a) treatment in specialized centres (Stroke Units; SU), (b) use of intravenous thrombolytic therapy (IVT), (c) use of endovascular thrombectomy (EVT) for patients with large vessel occlusions (LVO) and (d) rehabilitation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2022 Category: Neurology Authors: Konstantinos Dimitriadis, Ilias Kyriopoulos, Georgios Tsivgoulis, Konstantinos Vemmos, Wolfgang G. Kunz, Elias Mossialos Source Type: research

Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke Clinical Sciences
Conclusions— Prestroke disability does not seem to independently increase the risk of symptomatic intracranial hemorrhage after thrombolysis. Despite higher mortality, 1 in 3 previously disabled patients may return to his/her prestroke mRS. Therefore, they should not be routinely excluded from thrombolytic therapy.
Source: Stroke - February 24, 2014 Category: Neurology Authors: Karlinski, M., Kobayashi, A., Czlonkowska, A., Mikulik, R., Vaclavik, D., Brozman, M., Svigelj, V., Csiba, L., Fekete, K., Korv, J., Demarin, V., Vilionskis, A., Jatuzis, D., Krespi, Y., Ahmed, N., Wahlgren, N., for the Safe Implementation of Treatments i Tags: Thrombolysis Clinical Sciences Source Type: research

Acute Stroke Patients With Mild-to-Moderate Pre-existing Disability Should Be Considered for Thrombolysis Treatment
Thrombolytic therapy in patients with pre-existing disability presenting with acute ischemic stroke (AIS) is controversial because of concerns regarding poor outcomes and futility of treatment. We hypothesized that a similar proportion of patients with and without pre-existing disability would return to their premorbid functional status following thrombolysis.
Source: Journal of Stroke and Cerebrovascular Diseases - July 20, 2018 Category: Neurology Authors: Wenwen Zhang, Skye Coote, Tanya Frost, Helen M. Dewey, Philip M.C. Choi Source Type: research

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

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

Pre-hospital Triage of Acute Ischemic Stroke Patients —Importance of Considering More Than Two Transport Options
Conclusion: Pre-hospital triage algorithms for AIS patients that only take into account the nearest CSC and the nearest PSC as transport destinations may be unable to identify the optimal transport destination for a significant proportion of patients. Introduction Background International guidelines recommend early administration of intravenous thrombolysis for eligible patients with acute ischemic stroke (AIS); in addition, patients with proximal large vessel occlusion (LVO) should receive mechanical thrombectomy (MT) as quickly as possible (1). As the clinical benefit of both thrombolysis (2–4) and MT (5&#...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research