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Therapy: Thrombolytic Therapy

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IJERPH, Vol. 17, Pages 618: Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke
eng Tsong-Hai Lee Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagn...
Source: International Journal of Environmental Research and Public Health - January 17, 2020 Category: Environmental Health Authors: Yi-Ju Tseng Ru-Fang Hu Shin-Tyng Lee Yu-Li Lin Chien-Lung Hsu Shih-Wei Lin Chia-Wei Liou Jiann-Der Lee Tsung-I Peng Tsong-Hai Lee Tags: Article Source Type: research

Acute Ischemic Stroke.
Authors: Rossi UG, Ierardi AM, Cariati M Abstract A 77-year-old woman with a history of hypertension developed acute onset of aphasia and right hemiplegia and hemisensory loss. She was urgently referred to emergency department. Cerebral multidetector computed tomographic angiography (MD-CTA) revealed an acute ischemic stroke due to the occlusion of the left middle cerebral artery (Figure 1). Since the symptoms started three hours previously, the patient was candidate for mechanical thrombectomy. The patient then performed a selective digital subtraction angiography (DSA) of the left internal carotid artery that con...
Source: Acta Neurologica Taiwanica - February 1, 2020 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

Telemedicine remote controlled stroke evaluation and treatment, the experience of radiographers, paramedics and junior doctors in a novel rural stroke management team
CONCLUSIONS: The telemedicine-based, remote controlled, stroke evaluation and treatment was experienced, by the participants, to be well organised and of high quality. Communication and image reading appear to be the salient challenges. Regular training sessions and follow-up, as well as an evaluation of incidents by the project manager, proved to be of great importance in retaining and securing the continued running of the service and ensuring high-quality treatment. Further research is indicated in the comparison of this telemedicine service with stroke treatment given in a mainstream hospital.PMID:34090447 | DOI:10.1186/s12913-021-06591-1
Source: Rural Remote Health - June 6, 2021 Category: Rural Health Authors: Elin Kjelle Aud Mette Myklebust Source Type: research

Application of Mobile Stroke Unit in Prehospital Thrombolysis of Acute Stroke: Experience from China
Conclusion: Despite the small sample size, our preliminary experience of the application of MSU in the prehospital thrombosis therapy seems to indicate a significant reduction in time from call to needle, the efficacy of MSU in the treatment of acute stroke needs further experiment and larger sample size to confirm.Cerebrovasc Dis
Source: Cerebrovascular Diseases - June 25, 2021 Category: Neurology Source Type: research

Acute Ischemic Stroke With Mild Symptoms –To Thrombolyse or Not to Thrombolyse?
The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.
Source: Frontiers in Neurology - November 18, 2021 Category: Neurology Source Type: research

Neutrophil Extracellular Trap Targeting Protects Against Ischemic Damage After Fibrin-Rich Thrombotic Stroke Despite Non-Reperfusion
Stroke is one of the most prevalent diseases worldwide caused primarily by a thrombotic vascular occlusion that leads to cell death. To date, t-PA (tissue-type plasminogen activator) is the only thrombolytic therapy approved which targets fibrin as the main component of ischemic stroke thrombi. However, due to its highly restrictive criteria, t-PA is only administrated to less than 10% of all stroke patients. Furthermore, the research in neuroprotective agents has been extensive with no translational results from medical research to clinical practice up to now. Since we first described the key role of NETs (Neutrophil Ext...
Source: Frontiers in Immunology - February 16, 2022 Category: Allergy & Immunology Source Type: research

Risk factor identification and prediction models for prolonged length of stay in hospital after acute ischemic stroke using artificial neural networks
ConclusionThe artificial neural network model achieved adequate discriminative power for predicting prolonged length of stay after acute ischemic stroke and identified crucial factors associated with a prolonged hospital stay. The proposed model can assist in clinically assessing the risk of prolonged hospitalization, informing decision-making, and developing individualized medical care plans for patients with acute ischemic stroke.
Source: Frontiers in Neurology - February 9, 2023 Category: Neurology Source Type: research

Thrombolytic Agents for Acute Ischaemic Stroke Treatment: the Past, Present and Future.
Abstract Despite advances in the diagnosis and treatment of acute ischaemic stroke in the past two decades, stroke has remained the third cause of mortality and the single leading cause of disability worldwide. The immediate goal of acute ischaemic stroke therapy is to salvage the ischaemic penumbra through recanalisation of the occluded cerebral blood vessel. This is currently achieved through thrombolytics, which are pharmacological agents that can break up a clot blocking the flow of blood. To date, the only approved thrombolytic for treatment of acute ischaemic stroke is recombinant tissue plasminogen activato...
Source: CNS and Neurological Disorders Drug Targets - February 4, 2013 Category: Drugs & Pharmacology Authors: Balami JS, Chen R, Sutherland BA, Buchan AM Tags: CNS Neurol Disord Drug Targets Source Type: research

Intravenous thrombolysis in ischemic stroke with unknown onset using CT perfusion
ConclusionDelayed stroke patients with unknown onset time were no different than patients >4.5 h regarding eligibility and response to CTP‐based i.v. thrombolysis.
Source: Acta Neurologica Scandinavica - July 15, 2013 Category: Neurology Authors: E. Cortijo, P. García‐Bermejo, A. I. Calleja, S. Pérez‐Fernández, R. Gómez, J. M. del Monte, J. Reyes, J. F. Arenillas Tags: Original Article Source Type: research

The efficacy and safety of intravenous thrombolysis with alteplase in the treatment of ischaemic stroke in a rural hospital.
Conclusions: The indications for intravenous thrombolysis in patients with IS should be strictly analysed so that the treatment is effective and safe especially in older patients, patients with greater severity of neurological symptoms and patients with old post-stroke lesions in baseline CT. PMID: 23986420 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - September 3, 2013 Category: Neurology Authors: Sobolewski P, Sledzińska-Dźwigał M, Szczuchniak W, Hatalska-Żerebiec R, Grzesik M, Sobota A Tags: Neurol Neurochir Pol Source Type: research

Utilization of emergency medical service increases chance of thrombolytic therapy in patients with acute ischemic stroke.
CONCLUSIONS: Utilization of EMS can not only help acute ischemic stroke patients in early presentation to ED, but also effectively facilitate thrombolytic therapy and shorten the onset-to-needle time. PMID: 24296308 [PubMed - as supplied by publisher]
Source: J Formos Med Assoc - November 29, 2013 Category: Journals (General) Authors: Hsieh MJ, Tang SC, Chiang WC, Huang KY, Chang AM, Ko PC, Tsai LK, Jeng JS, Ma MH Tags: J Formos Med Assoc Source Type: research

Compliance with joint commission measures in state‐designated stroke centers
CONCLUSIONSNew Jersey state‐designated CSCs are better at adhering to the JC core stroke measures and have shorter door‐to‐thrombolytic drug times. Journal of Hospital Medicine 2013. © 2013 Society of Hospital Medicine
Source: Journal of Hospital Medicine - December 12, 2013 Category: Hospital Management Authors: Spozhmy Panezai, Tefera Gezmu, Jawad Kirmani, Florence Chukwuneke, Ratna Bitra, Abate Mammo, Martin Gizzi Tags: Original Research Source Type: research

Analysis of barriers to the use of thrombolytics in ischemic stroke in a private hospital in Rio de Janeiro, Brazil.
The objective was to discuss barriers to thrombolytic therapy in a private hospital. This was a retrospective cohort study of patients with symptoms of acute ischemic stroke entering the emergency department of a private hospital in Rio de Janeiro, Brazil, from 2009 to 2011. 257 patients were admitted with suspected ischemic stroke. Among the 156 patients with confirmed diagnosis of ischemic stroke, 18 (11.5%) received thrombolytic therapy. Of the 30 patients with ischemic stroke within the therapeutic window and meeting NIHSS criteria for thrombolysis, 20 were not thrombolysed. Nine of these were due to administrative bar...
Source: Cadernos de Saude Publica - December 1, 2013 Category: Global & Universal Authors: Fonseca LH, Rosa ML, Silva AC, Maciel RM, Volschan A, Mesquita ET Tags: Cad Saude Publica Source Type: research

Routine serum C‐reactive protein and stroke outcome after intravenous thrombolysis
ConclusionsAccording to our findings, elevated routine serum CRP measured within 24 h after admission does not seem to independently affect the outcome in patients receiving intravenous thrombolysis for stroke. However, further studies of blood samples taken directly before the treatment are needed.
Source: Acta Neurologica Scandinavica - February 20, 2014 Category: Neurology Authors: M. Karlinski, J. Bembenek, K. Grabska, A. Kobayashi, A. Baranowska, T. Litwin, A. Czlonkowska Tags: Original Article Source Type: research