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Specialty: Emergency Medicine
Therapy: Thrombolytic Therapy

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Total 33 results found since Jan 2013.

Mortality outcomes and predictors of failed thrombolysis following STEMI thrombolysis in a non-PCI capable tertiary hospital: a 5-year analysis
This study aimed to identify the incidence, mortality outcomes and predictors of FT in STEMI  pharmacological reperfusion. This single-centre retrospective cohort study analyzed data on consecutive STEMI patients who received thrombolytic therapy from 2016 to 2020 in a public tertiary hospital. Total population sampling was used in this study. Logistic regression analyses were used to asse ss independent predictors of the mortality outcomes and FT. We analyzed 941 patients with a mean age of 53.0 ± 12.2 years who were predominantly male (n = 846, 89.9%). The in-hospital mortality was 10.3% (n = 97). FT occur...
Source: Internal and Emergency Medicine - January 17, 2023 Category: Emergency Medicine Source Type: research

Effect of off-hour versus work-hour thrombolysis for acute ischemic stroke on emergency department patients’ outcome: a retrospective study
Conclusions In this study, there were no significant differences in mortality and functional outcomes at 3 months between patients who underwent off-hour or work-hour thrombolysis in the emergency department.
Source: European Journal of Emergency Medicine - March 10, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
ConclusionIn this study, patients with ischemic stroke in RRC group received intravenous thrombolytic therapy in a shorter time compared to the group that received usual care.
Source: International Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Source Type: research

A Case Report: An Acute Spinal Epidural Hematoma after Acupuncture Mimicking Stroke
Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately.
Source: The Journal of Emergency Medicine - March 19, 2020 Category: Emergency Medicine Authors: Chieh-Ling Chen, Ming-Hong Chang, Wei-Ju Lee Tags: Selected Topics: Neurological Emergencies Source Type: research

3-Month Outcome of Ischemic Stroke Patients Underwent Thrombolytic Therapy; a Cohort Study.
Conclusion: There was no significant correlation between 3-month disabilities of stroke patients underwent thrombolytic therapy and age, sex, time from initiation of symptoms, or vital signs on admission. Patients with a blood sugar lower than 144 had better 3-month outcome. PMID: 32021987 [PubMed]
Source: Accident and Emergency Nursing - February 7, 2020 Category: Emergency Medicine Authors: Sari Aslani P, Rezaeian S, Safari E Tags: Arch Acad Emerg Med Source Type: research

Multiple Administrations of Intravenous Thrombolytic Therapy to a Stroke Mimic
Patients who present emergently with focal neurological deficits concerning for acute ischemic stroke can be extremely challenging to diagnose and treat. Unnecessary administration of thrombolytics to potential stroke patients whose symptoms are not caused by an acute ischemic stroke —stroke mimics—may result in patient harm, although the overall risk of hemorrhagic complications among stroke mimics is low.
Source: The Journal of Emergency Medicine - December 1, 2019 Category: Emergency Medicine Authors: Ava L. Liberman, Daniel Antoniello, Steven Tversky, Michael G. Fara, Cen Zhang, Lindsey Gurin, Sara K. Rostanski Tags: Clinical Communications: Adult Source Type: research

Impact of CT scanner location on door to imaging time for emergency department stroke evaluation
Stroke is a potentially serious condition commonly diagnosed in the ED. Time to diagnosis can be crucial to maximizing outcome in a majority of ischemic stroke cases amenable to thrombolytic therapy.
Source: The American Journal of Emergency Medicine - August 13, 2019 Category: Emergency Medicine Authors: William Bonadio Source Type: research

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke
This study hypothesized that extending the time window for thrombolytic therapy to 9 hours after onset of symptoms in patients with a small core of infarction and a larger area of hypoperfusion would be beneficial.
Source: The Journal of Emergency Medicine - July 31, 2019 Category: Emergency Medicine Authors: Matthew W. Harrison, Amanda Young Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Tags: 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

Intravenous Thrombolysis for Ischemic Stroke Patients on Dual Antiplatets
In patients who receive intravenous thrombolytic therapy for ischemic stroke, prior use of dual antiplatelet therapy has been linked to high rates of adverse effects from tissue plasminogen activator (tPA). Specifically, increased rates of symptomatic intracranial hemorrhage have been reported. It is unclear if this is due to the antiplatelet therapy itself or due to other comorbidities present in patients typically prescribed dual antiplatelet therapy.
Source: The Journal of Emergency Medicine - December 1, 2018 Category: Emergency Medicine Authors: Lesley Catherine Pepin Source Type: research

Mobile Stroke Units: A Device in Search of an Indication
If you've been to any regional or national EMS conference in the last two years, you've seen these mobile stroke units. They are beautiful large ambulances with the latest and greatest in modern technology including mobile CT scanners. Often, the name of a hospital is blazoned on the side. There is usually a staff member present to tell you how great these will be for your community. But are they? Where's the science? What's the cost? These are important questions that should be asked and answered before these devices are deployed on a widespread basis. Although still somewhat controversial, therapies are now available to ...
Source: JEMS Patient Care - January 12, 2017 Category: Emergency Medicine Authors: Bryan Bledsoe, DO, FACEP, FAEMS Tags: Patient Care Source Type: news

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