Tissue Plasminogen Activator
A proteolytic enzyme in the serine protease family found in many tissues which converts PLASMINOGEN to FIBRINOLYSIN. It has fibrin-binding activity and is immunologically different from UROKINASE-TYPE PLASMINOGEN ACTIVATOR. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases.
An acylated inactive complex of streptokinase and human lysine-plasminogen. After injection, the acyl group is slowly hydrolyzed, producing an activator that converts plasminogen to plasmin, thereby initiating fibrinolysis. Its half-life is about 90 minutes compared to 5 minutes for TPA; (TISSUE PLASMINOGEN ACTIVATOR); 16 minutes for UROKINASE-TYPE PLASMINOGEN ACTIVATOR and 23 minutes for STREPTOKINASE. If treatment is initiated within 3 hours of onset of symptoms for acute myocardial infarction, the drug preserves myocardial tissue and left ventricular function and increases coronary artery patency. Bleeding complications are similar to other thrombolytic agents.
Urokinase-Type Plasminogen Activator
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.
Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY.
Coronary Care Units
Heart Rupture, Post-Infarction
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Angioplasty, Balloon, Coronary
A product of the lysis of plasminogen (profibrinolysin) by PLASMINOGEN activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins.
Carotid Artery Thrombosis
Emergency Medical Services
Intracranial Embolism and Thrombosis
Tomography, X-Ray Computed
The formation of an area of NECROSIS in the CEREBRUM caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., INFARCTION, ANTERIOR CEREBRAL ARTERY), and etiology (e.g., embolic infarction).
A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.
Emergency Medical Technicians
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing REPERFUSION INJURY.
Two small peptide chains removed from the N-terminal segment of the alpha chains of fibrinogen by the action of thrombin during the blood coagulation process. Each peptide chain contains 18 amino acid residues. In vivo, fibrinopeptide A is used as a marker to determine the rate of conversion of fibrinogen to fibrin by thrombin.
Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.
Newfoundland and Labrador
Randomized Controlled Trials as Topic
Streptodornase and Streptokinase
A mixture of the enzymes (streptokinase and streptodornase) produced by hemolytic streptococci. It is used topically on surface lesions and by instillation in closed body cavities to remove clotted blood or fibrinous or purulent accumulations. It is also used as a skin test antigen in evaluating generalized cell-mediated immunodeficiency. (Dorland, 27th ed) EC 3.-.
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
Predictive Value of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Infarction, Middle Cerebral Artery
NECROSIS occurring in the MIDDLE CEREBRAL ARTERY distribution system which brings blood to the entire lateral aspects of each CEREBRAL HEMISPHERE. Clinical signs include impaired cognition; APHASIA; AGRAPHIA; weak and numbness in the face and arms, contralaterally or bilaterally depending on the infarction.
Drug Therapy, Combination
Arterial Occlusive Diseases
Fibrin Fibrinogen Degradation Products
Ventricular Septal Rupture
Infarction, Anterior Cerebral Artery
NECROSIS occurring in the ANTERIOR CEREBRAL ARTERY system, including branches such as Heubner's artery. These arteries supply blood to the medial and superior parts of the CEREBRAL HEMISPHERE, Infarction in the anterior cerebral artery usually results in sensory and motor impairment in the lower body.
Vena Cava Filters
Single-chain polypeptides of about 65 amino acids (7 kDa) from LEECHES that have a neutral hydrophobic N terminus, an acidic hydrophilic C terminus, and a compact, hydrophobic core region. Recombinant hirudins lack tyr-63 sulfation and are referred to as 'desulfato-hirudins'. They form a stable non-covalent complex with ALPHA-THROMBIN, thereby abolishing its ability to cleave FIBRINOGEN.
Platelet Aggregation Inhibitors
Ventricular Dysfunction, Right
A condition in which the RIGHT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE or MYOCARDIAL INFARCTION, and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the right ventricular wall.
Ventricular Function, Left
Impaired conduction of cardiac impulse that can occur anywhere along the conduction pathway, such as between the SINOATRIAL NODE and the right atrium (SA block) or between atria and ventricles (AV block). Heart blocks can be classified by the duration, frequency, or completeness of conduction block. Reversibility depends on the degree of structural or functional defects.
Severity of Illness Index
Emergency Service, Hospital
Magnetic Resonance Imaging
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Heart Valve Prosthesis
Intra-Aortic Balloon Pumping
Counterpulsation in which a pumping unit synchronized with the patient's electrocardiogram rapidly fills a balloon in the aorta with helium or carbon dioxide in early diastole and evacuates the balloon at the onset of systole. As the balloon inflates, it raises aortic diastolic pressure, and as it deflates, it lowers aortic systolic pressure. The result is a decrease in left ventricular work and increased myocardial and peripheral perfusion.
Clinical Trials as Topic
Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Magnetic Resonance Angiography
Confounding Factors (Epidemiology)
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.
Tomography, Emission-Computed, Single-Photon
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
Drug Administration Schedule
Ultrasonography, Doppler, Transcranial
A non-invasive technique using ultrasound for the measurement of cerebrovascular hemodynamics, particularly cerebral blood flow velocity and cerebral collateral flow. With a high-intensity, low-frequency pulse probe, the intracranial arteries may be studied transtemporally, transorbitally, or from below the foramen magnum.
Middle Cerebral Artery
The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.
Combined Modality Therapy
Coronary Artery Bypass
Disease Models, Animal
Immunoglobulin Fab Fragments
Univalent antigen-binding fragments composed of one entire IMMUNOGLOBULIN LIGHT CHAIN and the amino terminal end of one of the IMMUNOGLOBULIN HEAVY CHAINS from the hinge region, linked to each other by disulfide bonds. Fab contains the IMMUNOGLOBULIN VARIABLE REGIONS, which are part of the antigen-binding site, and the first IMMUNOGLOBULIN CONSTANT REGIONS. This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme PAPAIN.
Sensitivity and Specificity
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Physician's Practice Patterns
Diffusion Magnetic Resonance Imaging
A diagnostic technique that incorporates the measurement of molecular diffusion (such as water or metabolites) for tissue assessment by MRI. The degree of molecular movement can be measured by changes of apparent diffusion coefficient (ADC) with time, as reflected by tissue microstructure. Diffusion MRI has been used to study BRAIN ISCHEMIA and tumor response to treatment.
Carotid Artery, Internal
Optimal thrombolytic strategies for acute myocardial infarction--bolus administration. (1/2653)Optimal strategies for thrombolysis in myocardial infarction (TIMI) are still being sought because the TIMI 3 flow rates achievable using standard regimens average approximately 60%. Double bolus administration of recombinant tissue plasminogen activator (tPA) is a novel approach with potential for earlier patency combined with ease of administration. We reviewed total patency rates, TIMI 3 patency rates, mortality, stroke and intracranial haemorrhage rates in the major trials of accelerated infusion tPA/bolus tPA/reteplase in acute myocardial infarction. A direct comparison was performed with results of two recent trials of double bolus (two 50 mg boli, 30 min apart) vs. accelerated infusion tPA: the Double Bolus Lytic Efficacy Trial (DBLE), an angiographic study, and the COBALT Trial, a mortality study. The DBLE trial showed equivalent patency rates for accelerated infusion and double bolus administration of tPA. Reviewing other angiographic trials, total patency and TIMI 3 patency rates achievable with double bolus tPA were comparable to those with accelerated infusion tPA or bolus reteplase administration. The COBALT study demonstrated a 30-day mortality of 7.53% in patients treated with accelerated infusion tPA compared with 7.98% for double bolus tPA treated patients. The small excess in mortality with double bolus treatment was confined to the elderly; in those < or = 75 years, mortality rates were 5.6% and 5.7%, for double bolus and accelerated infusion, respectively, and rates for death or non-fatal stroke were 6.35% and 6.3%, respectively. Comparison with other trials demonstrated mortality, stroke and intracranial haemorrhage rates with double bolus treatment similar to those associated with either accelerated infusion tPA or bolus reteplase treatment. Double bolus administration of tPA to patients with acute myocardial infarction is associated with total patency, TIMI 3 patency, mortality, stroke and intracranial haemorrhage rates similar to those associated with either accelerated infusion of tPA or bolus reteplase. (+info)
Age-related outcome for peripheral thrombolysis. (2/2653)OBJECTIVES: To investigate the age-related outcome of peripheral thrombolysis and determine for which patient group this treatment is worthwhile. DESIGN AND METHODS: A combined retrospective and prospective analysis of consecutive patients undergoing thrombolysis for acute lower-limb ischaemia was made with respect to age-related outcome and other risk factors. RESULTS: One hundred and two patients underwent thrombolysis for acute limb ischaemia. In the under 60 age group there was a 40% amputation rate. Seventy-three per cent of this group smoked. In the over 80 age group, the amputation rate was 15% and only 8% were smokers. CONCLUSION: Advancing age is not an adverse risk factor for thrombolysis which appears to be safe and effective in this patient group. There is a high incidence of smoking in the younger age group (< 60 years), in whom failed thrombolysis frequently leads to amputation. (+info)
Delayed increase in infarct volume after cerebral ischemia: correlations with thrombolytic treatment and clinical outcome. (3/2653)BACKGROUND AND PURPOSE: Growing experimental evidence indicates that the development of cerebral ischemic damage is slower than previously believed. The aims of this work were (1) to study the evolution of CT hypoattenuation between 24 to 36 hours and 7 days in ischemic stroke patients; (2) to evaluate whether thrombolytic treatment given within 6 hours of stroke affects delayed infarction evolution; and (3) to investigate possible correlations between lesion volume changes over time and clinical outcome. METHODS: Of 620 patients included in the European Cooperative Acute Stroke Study 1 (ECASS1), we selected 450 patients whose control CT scans at day 1 (CT1) and day 7 (CT7) were available. They had been randomly divided into 2 groups: 206 patients had been treated with rtPA and 244 with placebo. CT1 and CT7 were classified according to the location of the infarct. The volume of CT hypoattenuation was measured using the formula AxBxC/2 for irregular volumes. The 95% confidence interval of inter- and intrarater variability was used to determine whether significant changes in lesion volume had occurred between CT1 and CT7. Clinical severity was evaluated by means of the Scandinavian Stroke Scale (SSS) at entry (SSS0) and at day 30 (SSS30). RESULTS: Mean lesion volumes were significantly (P<0.0001) higher at day 7 than at day 1 in all the subgroups of patients and particularly in patients with a subcortical lesion. Of the 450 patients studied, 287 (64%) did not show any significant change in lesion volume between CT1 and CT7, 143 (32%) showed a significant increase and the remaining 20 (4%) a significant decrease. No significant correlation was observed between treatment and lesion evolution between CT1 and CT7. Both clinical scores (SSS0 and SSS30) and degree of neurological recovery were significantly (P<0.05) lower in the subgroup of patients with a significant lesion volume increase than in the other 2 groups. CONCLUSIONS: In approximately two thirds of patients, infarct size is established 24 to 36 hours after stroke onset, whereas in the remaining one third, changes in lesion volume may occur later than the first 24 to 36 hours. Many factors may be responsible for delayed infarct enlargement and for a lower degree of clinical recovery, both of which may occur despite early recombinant tissue plasminogen activator treatment. (+info)
Thrombolysis with tissue plasminogen activator alters adhesion molecule expression in the ischemic rat brain. (4/2653)BACKGROUND AND PURPOSE: We tested the hypothesis that treatment of embolic stroke with recombinant human tissue plasminogen activator (rhtPA) alters cerebral expression of adhesion molecules. METHODS: Male Wistar rats were subjected to middle cerebral artery occlusion by a single fibrin-rich clot. P-selectin, E-selectin, and intercellular adhesion molecule-1 (ICAM-1) immunoreactivity was measured at 6 or 24 hours after embolic stroke in control rats and in rats treated with rhtPA at 1 or 4 hours after stroke. To examine the therapeutic efficacy of combined rhtPA and anti-ICAM-1 antibody treatment at 4 hours after embolization, ischemic lesion volumes were measured in rats treated with rhtPA alone, rats treated with rhtPA and anti-ICAM-1 antibody, and nontreated rats. RESULTS: Administration of rhtPA at 1 hour after embolization resulted in a significant reduction of adhesion molecule vascular immunoreactivity after embolization in the ipsilateral hemisphere compared with corresponding control rats. However, when rhtPA was administered to rats at 4 hours after embolization, significant increases of adhesion molecule immunoreactivity in the ipsilateral hemisphere were detected. A significant increase of ICAM-1 immunoreactivity was also detected in the contralateral hemisphere at 24 hours after ischemia. A significant reduction in lesion volume was found in rats treated with the combination of rhtPA and anti-ICAM-1 antibody compared with rats treated only with rhtPA. CONCLUSIONS: The present study suggests that the time of initiation of thrombolytic therapy alters vascular immunoreactivity of inflammatory adhesion molecules in the ischemic brain and that therapeutic benefit can be obtained by combining rhtPA and anti-ICAM-1 antibody treatment 4 hours after stroke. (+info)
Carotid endarterectomy and intracranial thrombolysis: simultaneous and staged procedures in ischemic stroke. (5/2653)PURPOSE: The feasibility and safety of combining carotid surgery and thrombolysis for occlusions of the internal carotid artery (ICA) and the middle cerebral artery (MCA), either as a simultaneous or as a staged procedure in acute ischemic strokes, was studied. METHODS: A nonrandomized clinical pilot study, which included patients who had severe hemispheric carotid-related ischemic strokes and acute occlusions of the MCA, was performed between January 1994 and January 1998. Exclusion criteria were cerebral coma and major infarction established by means of cerebral computed tomography scan. Clinical outcome was assessed with the modified Rankin scale. RESULTS: Carotid reconstruction and thrombolysis was performed in 14 of 845 patients (1.7%). The ICA was occluded in 11 patients; occlusions of the MCA (mainstem/major branches/distal branch) or the anterior cerebral artery (ACA) were found in 14 patients. In three of the 14 patients, thrombolysis was performed first, followed by carotid enarterectomy (CEA) after clinical improvement (6 to 21 days). In 11 of 14 patients, 0.15 to 1 mIU urokinase was administered intraoperatively, ie, emergency CEA for acute ischemic stroke (n = 5) or surgical reexploration after elective CEA complicated by perioperative intracerebral embolism (n = 6). Thirteen of 14 intracranial embolic occlusions and 10 of 11 ICA occlusions were recanalized successfully (confirmed with angiography or transcranial Doppler studies). Four patients recovered completely (Rankin 0), six patients sustained a minor stroke (Rankin 2/3), two patients had a major stroke (Rankin 4/5), and two patients died. In one patient, hemorrhagic transformation of an ischemic infarction was detectable postoperatively. CONCLUSION: Combining carotid surgery with thrombolysis (simultaneous or staged procedure) offers a new therapeutic approach in the emergency management of an acute carotid-related stroke. Its efficacy should be evaluated in interdisciplinary studies. (+info)
The surgical management of acute limb ischaemia due to native vessel occlusion. (6/2653)OBJECTIVES: Data from the STILE study have indicated that for patients with subacute limb ischaemia due to native vessel occlusion, surgery is both more effective, and durable than thrombolysis. The purpose of this study was to evaluate the outcome of an aggressive surgical approach in patients presenting with acute limb-threatening ischaemia. DESIGN: Details of patients presenting with salvageable acute limb ischaemia due to native artery occlusion over a 6-year period in a University hospital vascular unit setting were obtained from the vascular audit and the outcome of the surgical management of these patients was analysed. RESULTS: One hundred and seventy-four consecutive patients underwent surgery for acute native vessel limb ischaemia (76% lower, 24% upper limb). Fogarty thrombectomy or embolectomy was initially performed in 153 (89%) patients. Of these, 37 (24%) immediately underwent a further procedure: 28 (18%) had on-table thrombolysis and 14 (9%) underwent vascular reconstruction. Twenty-six patients (15%) underwent further limb salvage surgery within 30 days. Life table analysis demonstrated a limb salvage rate of 88% and 76% at 30 days and 2 years, respectively. Patient survival was 75% and 48% at the same time intervals. CONCLUSIONS: These results demonstrate that a role for aggressive surgical intervention still exists, resulting in high limb salvage rates. (+info)
Recombinant soluble form of PSGL-1 accelerates thrombolysis and prevents reocclusion in a porcine model. (7/2653)BACKGROUND: We investigated whether administration of a soluble recombinant P-selectin glycoprotein ligand-1 chimera (rPSGL-Ig) in conjunction with thrombolytic therapy would enhance thrombolysis by preventing ongoing interactions of leukocytes with platelets and the injured arterial wall. METHODS AND RESULTS: An occlusive thrombus was formed in an internal iliac artery of Yorkshire pigs by placement of a copper coil in the artery under fluoroscopic guidance. Pigs then received heparin and, 15 minutes later, either vehicle or rPSGL-Ig followed by infusion with 25 mg tissue plasminogen activator according to the 90-minute regimen. Blood flow through the artery was monitored by angiography and scored on a scale of 0 to 3. Lysis of the thrombus was accelerated by 70% in pigs treated with rPSGL-Ig 250 microg/kg compared with control (13.3+/-5.0 versus 44. 4+/-13.3 minutes; n=9 each). Eight of 9 control pigs reoccluded in 13.8+/-16.9 minutes after the end of tissue plasminogen activator infusion, whereas no reocclusion was observed in 8 of 9 pigs in the rPSGL-Ig group. When the dose of rPSGL-Ig was increased to 500 microg/kg, time to lysis was shortened by 61% from control (18.0+/-8. 4 versus 46.0+/-8.9 minutes). Reocclusion occurred in 6.0+/-15.2 minutes in control but not in any rPSGL-Ig-treated pig (n=5 each). In addition, near-normal flow (score 2 or 3) after thrombolysis was achieved 59% and 58% faster in the 2 rPSGL-Ig groups than in their respective controls. CONCLUSIONS: Inhibition of leukocyte accumulation at the site of thrombosis with rPSGL-Ig may represent a safe therapeutic intervention that could be important in accelerating thrombolysis, achieving optimal reperfusion, and reducing incidence of acute reocclusion. (+info)
Primary angioplasty versus systemic thrombolysis in anterior myocardial infarction. (8/2653)OBJECTIVES: This study compares the efficacy of primary angioplasty and systemic thrombolysis with t-PA in reducing the in-hospital mortality of patients with anterior AMI. BACKGROUND: Controversy still exists about the relative benefit of primary angioplasty over thrombolysis as treatment for AMI. METHODS: Two-hundred and twenty patients with anterior AMI were randomly assigned in our institution to primary angioplasty (109 patients) or systemic thrombolysis with accelerated t-PA (111 patients) within the first five hours from the onset of symptoms. RESULTS: Baseline characteristics were similar in both groups. Primary angioplasty was independently associated with a lower in-hospital mortality (2.8% vs. 10.8%, p = 0.02, adjusted odds ratio 0.23, 95% confidence interval 0.06 to 0.85). During hospitalization, patients treated by angioplasty had a lower frequency of postinfarction angina or positive stress test (11.9% vs. 25.2%, p = 0.01) and less frequently underwent percutaneous or surgical revascularization after the initial treatment (22.0% vs. 47.7%, p < 0.001) than did patients treated by t-PA. At six month follow-up, patients treated by angioplasty had a lower cumulative rate of death (4.6% vs. 11.7%, p = 0.05) and revascularization (31.2% vs. 55.9%, p < 0.001) than those treated by t-PA. CONCLUSIONS: In centers with an experienced and readily available interventional team, primary angioplasty is superior to t-PA for the treatment of anterior AMI. (+info)
Increase in national intravenous thrombolysis rates for ischaemic stroke between 2005 and 2012: is bigger better? | BMC...
Total volume of stroke admissions per stroke service was not an independent predictor of mean thrombolysis rate nor of mean DNT. For the year of 2012 we also found no significant relationship between volume of stroke admissions and mean thrombolysis rates or mean DNT, when corrected for age, gender and type of hospital. There was a trend, towards higher thrombolysis rates in larger centers. When looking at the relationship between volume and DNT there seems to be a weak but significant relationship. Significance disappears when correction is used for age, gender and type of hospital. Interestingly, academic centers had higher thrombolysis rates, and lower DNTs together with non-academic referral centers, as compared to regional hospitals. So, even though there is a trend suggesting that larger volumes account for better results, this by no means reaches statistical significance, but organisational issues play a role in these process measures. This finding is in line with many previous studies ...
Graded exercise testing following thrombolytic therapy for acute myocardial infarction: the importance of timing and infarct...
Graded exercise testing following thrombolytic therapy for acute myocardial infarction: the importance of timing and infarct location. TPAT Study Group.
The relationship of intracoronary stent placement following thrombolytic therapy to tissue level perfusion<...
TY - JOUR. T1 - The relationship of intracoronary stent placement following thrombolytic therapy to tissue level perfusion. AU - Gibson, C. M.. AU - Frisch, D.. AU - Murphy, S. A.. AU - Gourlay, S. G.. AU - Gibbons, Raymond J. AU - Baran, K. W.. AU - Nguyen, M.. AU - Palmeri, S.. AU - Barron, H. V.. PY - 2002. Y1 - 2002. N2 - Background: Stenting has been shown to improve lumen diameters and thereby improve epicardial blood flow, but the impact of stent placement on tissue level perfusion has not been well characterized. Methods: Data were drawn from the LIMIT trial of rhuMAb CD18 (anti WBC antibody) in acute myocardial infarction (AMI). Adjunctive/rescue stenting was performed at the discretion of the investigator. The TIMI Myocardial Perfusion Grade (TMPG) was assessed and digital subtraction angiography (DSA) was used to quantify brightness of the myocardial blush. Results: TIMI 3 flow was 54.2% (64/118) before stent placement, and improved to 87.2% (102/117, p , 0.001) following stent ...
Computed tomography scan following thrombolytic therapy | Open-i
Computed tomography scan following thrombolytic therapy. (A) Reperfusion of the branches of the (A) right and (B) left pulmonary arteries. (C) Normalization of
Retrospective observational case-control study comparing prehospital thrombolytic therapy for ST-elevation myocardial...
We believe that this study is the first that has used a case-control series to compare prehospital with in-hospital thrombolytic therapy. Although our study contains relatively small numbers and could not be expected to provide the strength of evidence of a larger prospective randomised controlled trial, the phased development of delivery of prehospital thrombolytic therapy in Wyre Forest has allowed us to compare the time of treatment administration and examine the subsequent outcomes in two matched groups of patients.. In our series prehospital thrombolytic therapy resulted in much earlier delivery of treatment with a median time saving of 66 minutes, compared to thrombolytic therapy given after arrival in hospital. The results of previous randomised trials of thrombolytic therapy show an inverse relationship between the reduction in mortality and the length of time from onset of symptoms to treatment,6 and this has driven various approaches to try delivering treatment as early as possible. ...
10 Best Clinics for Intravenous Thrombolytic Therapy in Wiesbaden [2021 Prices]
Intravenous Thrombolytic Therapy clinics in Wiesbaden at the best price. Find doctors, specialized in Vascular Medicine and compare prices, costs and reviews.
10 Best Clinics for Intravenous Thrombolytic Therapy in France [2020 Prices]
Intravenous Thrombolytic Therapy clinics in France at the best price. Find doctors, specialized in Vascular Medicine and compare prices, costs and reviews.
CT patterns of intracranial hemorrhage complicating thrombolytic therapy for acute myocardial infarction<...
TY - JOUR. T1 - CT patterns of intracranial hemorrhage complicating thrombolytic therapy for acute myocardial infarction. AU - Uglietta, J. P.. AU - OConnor, C. M.. AU - Boyko, O. B.. AU - Aldrich, H.. AU - Massey, E. W.. AU - Heinz, E. R.. PY - 1991/1/1. Y1 - 1991/1/1. N2 - Computed tomographic (CT) patterns of intracranial hemorrhage (ICH) were determined in 1,696 patients undergoing thrombolytic therapy for acute myocardial infarction. ICH occurred at 33 sites in 0.77% of patients (n = 13). Thirty-six percent of hemorrhages (n = 12) were intraparenchymal, 33% (n = 11) were subdural, 24% (n = 8) were subarachnoid, and 6% (n = 2) were intraventricular. Eighty-four percent (n = 26) of all nonventricular hemorrhages were supratentorial in location. The most common site of ICH was supratentorial and intraparenchymal (10 of 33). In 11 of the 13 patients with ICH, clinical symptoms occurred within 24 hours of the initiation of thrombolytic therapy. A fatal outcome resulted in three of the four ...
Use of CT angiography in patient selection for thrombolytic therapy<...
TY - JOUR. T1 - Use of CT angiography in patient selection for thrombolytic therapy. AU - Chuang, Yu Ming. AU - Chao, A. Ching. AU - Teng, Michael Mu Ho. AU - Wu, Hsiu Mei. AU - Lirng, Jiing Feng. AU - Wu, Zin An. AU - Chiang, Jen Huey. AU - Hu, Han Hwa. PY - 2003/1/1. Y1 - 2003/1/1. N2 - It has been shown that thrombolytic therapy can improve clinical outcome in some patients with acute cerebral ischemia. These patients have been reported to be characterized by certain clinical and imaging findings, mainly with non-contrast enhanced computed tomography (CT). Our purpose in this study was to find out whether CT angiography (CTA) information about the status of the cerebral vessels is helpful in the selection of patients who may benefit the most from thrombolytic therapy for acute cerebral ischemia. CTA was prospectively performed in 15 consecutive patients (6 women and 9 men; age range 44-83 years) with moderate or severe symptoms of hyperacute cerebral ischemia. The clinical manifestations of ...
Best Thrombolytic Therapy Doctor in Mumbai, Thrombolytic Therapy Doctors | Credihealth
Find the best thrombolytic therapy doctors in Mumbai. Get guidance from medical experts to select thrombolytic therapy specialist in Mumbai from trusted hospitals - credihealth.com
ST segment monitoring for coronary artery reocclusion following thrombolytic therapy and coronary angioplasty: identification...
BACKGROUND: Bedside ST segment monitors analyze only one precordial lead and one, two or three limb leads. The precordial lead V1 (or V6 if V1 is not feasible) has been recommended for bedside monitoring because of its value in diagnosing cardiac rhythms with a wide QRS complex. Thus, the remaining lead choices for ST monitoring are limited to the six limb leads. PURPOSE: To determine which of the limb leads in conjunction with V1 or V6 provides the greatest sensitivity for myocardial ischemia, a study was undertaken. METHOD: A total of 30 vessel-unique ischemic episodes were analyzed prospectively using continuous 12-lead electrocardiographic recordings in patients with acute myocardial infarction (n = 2) and patients undergoing coronary angioplasty (n = 25). RESULTS: Ischemic changes were evident in all cases using the full 12-lead electrocardiogram. Right coronary artery-related ischemia was detected in all cases using a single-lead III or aVF. In the group as a whole, the best combinations ...
Intra-Arterial Thrombolysis for Left Middle Cerebral Artery Embolic Stroke During Coronary Angiography | Circulation
Catheterization-related strokes are rare (0.07% to 0.38%)1,2 and almost always are of embolic origin. Emboli can originate from dislodgement of material from plaque rupture, calcium from aortic cusps, or thrombus formation in the catheters or on the guides.3-5 Furthermore, the apposition of thrombus to the embolic material may be an important component of cerebral artery occlusion. Computed tomography scan and magnetic resonance imaging seem to be unnecessary because they do not add anything to the diagnosis and treatment. An immediate carotid angiogram to assess cerebral artery occlusion appears to be the best and least time-consuming approach. Hemorrhagic stroke can be recognized by extravasation or late persistence of contrast. Recent studies comparing intra-arterial and intravenous thrombolytic therapy in thromboembolic stroke have shown a higher rate of revascularization with intra-arterial thrombolysis.6,7 Previous trials have shown the safety and efficacy of intra-arterial thrombolysis ...
A Case of Acute Myocardial Infarction after Thrombolytic Therapy for Mechanical Valve Dysfunction in the Late Postoperative...
The patient was a 65-year-old man who had undergone AVR iSJM Regent:19 mm jfor AR in June 2007. Since March 2008 there had been an increase in the pressure gradient between the aorta and the left ventricle on transthoracic echocardiography ipeak PG:46mmHg, mean PG:27 mmHg). Plain x-ray films of the valve showed limited opening of the metallic valve. However, no symptoms of heart failure were observed on a physical examination. Blood tests performed in December 2007 showed a PT-INR value of 1.22. Since the effects of warfarin anticoagulant therapy were insufficient, its dose was adjusted on follow-up. An examination in June revealed further stenosis of the valve ipeak PG:93mmHg, mean PG:58 mmHg). Valve thrombosis was suspected because the condition was poorly controlled by warfarin. Thus, thrombolytic therapy using t-PA was performed i800,000 units). However, the patient complained of chest pain 1 h 30 min after initiation of thrombolytic therapy. Twelve-lead electrocardiography was performed, ...
Hospitalization Costs for Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis in the United States Are...
The 2008 median cost of hospitalization for patients 65 years or older treated with intravenous thrombolysis was $13 802 for those with a good outcome, which does not compare favorably with the average 2008 Medicare payment of $10 098 for intravenous thrombolysis without (MS-DRG 063) complication. Similarly, the median hospital costs of $18 405 for patients with morbidity and $17 406 for patients with mortality do not compare favorably with the average 2008 Medicare payment of $13 835 for intravenous thrombolysis with major complication (MS-DRG 061).. Medicare reimbursements for hospitalization are based on the Diagnosis-Related Group (DRG) for the patient visit. Each admission is assigned one DRG, and under that DRG the hospital is paid a predetermined lump sum regardless of the costs associated with care. For example, if a patient was assigned the DRG 061 and the cost of care was $20 000, then the hospital would lose ≈$6000 for that patients care. The DRG system is in place to incentivize ...
Administration of thrombolytic therapy to patients with acute myocardial infarction - Kingston University Research Repository
The publication of large randomised trials such as ISIS 2 (1988) and AIMS (1990), provided striking evidence as to the effectiveness of thrombolytic therapy in reducing early mortality and morbidity in patients suffering acute myocardial infarction. This article will provide an overview of the use of thrombolytic agents in modern cardiac care, with particular reference to their impact on the Accident and Emergency department.. ...
Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A Computed Tomography Angiography...
Materials and Methods: Data of patients treated with IV rt-PA within 4.5 hours of symptom onset between March 2015 and January 2017 were retrospectively analyzed. Patients were divided into two groups; those with isolated MCA occlusion and those with no large vessel occlusion. Large vessel occlusion was detected with contrast-enhanced computed tomography angiography performed before IV rt-PA. Additionally, demographic and clinical data of the patients were analyzed. The clinical outcomes of the patients were determined using the modified Rankin Scale (mRS) score at 3 months after treatment ...
Audit of prehospital thrombolysis by general practitioners in peripheral practices in Grampian | Heart
In GREAT, median call-to-needle times were 55 and 185 minutes for prehospital and hospital groups; 90% and 1% of measurements were ⩽ 90 minutes, respectively.1 In this audit, comprising many of the same practices that took part in the trial, the corresponding times were improved, at 45 minutes for prehospital thrombolysis, and 145 minutes for hospital thrombolysis. The improvement is most marked for the hospital group, where call-to-needle times were 40 minutes shorter in the audit than in the trial. This was largely owing to shortening of door-to-needle times in hospital, from 87 minutes in GREAT (estimated mean), to 35 minutes (median) in this audit.. Call-to-opiate times give an indication of the first opportunity for thrombolysis, which may be initiated about 15 minutes after opiate is given. In both prehospital and hospital groups, median call-to-opiate times were about half an hour.. In some rural areas of Scotland, thrombolytic treatment is given by general practitioners in community ...
Taipei Medical University Shuang Ho Hospital
Stroke is the third-leading cause of death in Taiwan that shows the importance of stroke treatment. Stroke is a severe injury of brain in a short time but its complications could last a very long time. The Stroke Center of Shuang Ho Hospital was formed in 2009, in order to provide state-of-art medical care of stroke around Jhonghe area. The Stroke Center of Shuang Ho Hospital, consists of a strong multi-discipline team, provides the medical services which combine with several specialties, such as Emergency medicine, Neurology, Neurosurgery, Neuroradiology, Rehabilitation and Pharmacy. In acute ischemic stroke, our intravenous thrombolytic therapy (IV tPA) door-to-needle time is around 60 minutes and our neuroradiology team could do intra-arterial thrombolytic therapy within one hour if needed. Stroke is an emergent condition. To improve the outcome of stroke, peoples awareness of diseases and an outstanding stroke team are both essential. Shung Ho Hospital stroke center is well-prepared to ...
Effect of Thrombolytic Therapy on the Evolution of Baroreceptor Sensitivity After Myocardial Infarction | Clinical Science
Thank you for your interest in spreading the word about Clinical Science.. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.. ...
Relationships between brain perfusion and early recanalization after intravenous thrombolysis for acute stroke with large...
In large vessel occlusion (LVO) stroke, it is unclear whether severity of ischemia is involved in early post-thrombolysis recanalization over and above thrombus site and length. Here we assessed the relationships between perfusion parameters and early recanalization following intravenous thrombolysis administration in LVO patients. From a multicenter registry, we identified 218 thrombolysed LVO patients referred for thrombectomy with both (i) pre-thrombolysis MRI, including diffusion-weighted imaging (DWI), T2*-imaging, MR-angiography and dynamic susceptibility-contrast perfusion-weighted imaging (PWI); and (ii) evaluation of recanalization on first angiographic run or non-invasive imaging 3 h from thrombolysis start. Infarct core volume on DWI, PWI-DWI mismatch volume and hypoperfusion intensity ratio (HIR; defined as Tmax ! 10 s volume/ Tmax ! 6 s volume, low HIR indicating milder hypoperfusion) were determined using a commercially available software. Early recanalization occurred in 34 (16%) patients
Rescue angioplasty reduced cardiovascular and cerebrovascular outcomes in acute MI after failed thrombolytic therapy | Annals...
Suarez A, Rajdev S, Hillegass WB. Rescue angioplasty reduced cardiovascular and cerebrovascular outcomes in acute MI after failed thrombolytic therapy. ACP J Club. 2006;144:60. doi: 10.7326/ACPJC-2006-144-3-060. Download citation file:. ...
Age-Specific Differences in the Use of Thrombolytic Therapy and Hospital Outcomes in Patients with Acute Myocardial Infarction:...
Background: Relatively limited information is available about recent, and trends over time, use of thrombolytic therapy in patients of different ages hospitalized with acute myocardial infarction and
Prehospital thrombolytic therapy in patients with suspected acute myocardial infarction
Prehospital thrombolytic therapy for patients with suspected myocardial infarction is both feasible and safe when administered by well-equipped, well-trained mobile emergency medical staff. Although such therapy appears to reduce mortality from cardiac causes, our data do not definitely establish th …
Avoiding Pseudo-Reversibility of CT-CBV Infarct Core Lesions in Acute Stroke Patients After Thrombolytic Therapy | Stroke
We demonstrated that standard CT-CBV maps calculated with deconvolution can overestimate infarct core, but when CT-CBV maps are processed with algorithmically optimized delay-correction software, recovery of tissue with a low CBV is rare. Specifically, standard CT-CBV maps demonstrated abnormalities larger than final infarct volumes in 11/148 (7.4%) AIS patients treated with thrombolytic therapy. However, only 2 patients had delay-corrected CT-CBV abnormalities that were larger than final infarct volumes, and the decreases in lesion size were small. These findings correlate with reports demonstrating that final infarcts are rarely smaller than initial DWI abnormalities.3. Delayed tracer bolus arrival can be attributed to extracranial and intracranial factors. Extracranial factors include AF, CHF, and ICA stenosis. Intracranial causes include thrombus extent and poor collateralization. In patients with these factors who demonstrate a large CT-CBV defect, arterial, venous, and tissue curves ...
Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial...
Dive into the research topics of Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial infarction: Mechanism of the smokers paradox from the GUSTO-I trial, with angiographic insights. Together they form a unique fingerprint. ...
Failure of simple clinical measurements to predict perfusion status after intravenous thrombolysis<...
TY - JOUR. T1 - Failure of simple clinical measurements to predict perfusion status after intravenous thrombolysis. AU - Califf, R. M.. AU - ONeil, W.. AU - Stack, R. S.. AU - Aronson, L.. AU - Mark, D. B.. AU - Mantell, S.. AU - George, B. S.. AU - Candela, R. J.. AU - Kereiakes, D. J.. AU - Abbottsmith, C.. AU - Topol, E. J.. AU - ONeill, W. W.. AU - Walton, J. A.. AU - Bates, E. R.. AU - Ellis, S. G.. AU - Bourdillon, P. D V. AU - Schork, M. A.. AU - Kline, E.. PY - 1988/1/1. Y1 - 1988/1/1. N2 - To determine whether coronary patency could be detected early during thrombolytic therapy, commonly used markers of perfusion were recorded in 386 patients with acute myocardial infarction treated with tissue plasminogen activator. Infarct artery angiography 90 minutes after initiation of therapy was used to determine perfusion status. Of patients with complete resolution of ST segment elevation before the angiogram, 96% (95% confidence interval, 79% to 100%) showed perfusion on the angiogram, and ...
Effect of early intravenous heparin on coronary patency, infarct size, and bleeding complications after alteplase thrombolysis:...
OBJECTIVE--To determine whether concomitant treatment with intravenous heparin affects coronary patency and outcome in patients treated with alteplase thrombolysis for acute myocardial infarction. DESIGN--Double blind randomised trial. TREATMENT REGIMENS--Alteplase 100 mg (not weight adjusted) plus aspirin (250 mg intravenously followed by 75-125 mg on alternate days) plus heparin (5000 units intravenously followed by 1000 units hourly without dose adjustment) was compared with alteplase plus aspirin plus placebo for heparin. SETTING--19 cardiac centres in six European countries. SUBJECTS--652 patients aged 21-70 years with clinical and electrocardiographic features of infarcting myocardium in whom thrombolytic therapy could be started within six hours of the onset of major symptoms. MAIN OUTCOME MEASURE--Angiographic coronary patency 48-120 hours after randomisation. RESULTS--Coronary patency (TIMI grades 2 or 3) was 83.4% in the heparin group and 74.7% in the group given placebo for heparin. ...
Tips From Other Journals - American Family Physician
Stroke is the leading cause of adult long-term disability in the United States and the third leading cause of death, following heart disease and cancer. The outcome of ischemic stroke is generally determined by the natural course with applied supportive methods. The use of tissue plasminogen activator (tPA) is an effort to intervene in this natural progression to disability and death.. Osborn and associates reviewed the large trials of thrombolytic therapy in the treatment of patients with ischemic stroke. A previous meta-analysis of several trials of thrombolytic therapy demonstrated a higher risk of mortality in patients who received thrombolytic therapy than in patients who did not, but individual study variations make this conclusion questionable. Careful examination of individual thrombolytic trials to discern differences might indicate a particularly beneficial treatment protocol. Specific parameters from the studies include (1) thrombolytic agent administered, (2) interpretation of ...
Thrombolytic Therapy | Sutter Health
Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke.
Thrombolytic Therapy | Sutter Health
Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke.
Mechanical Thrombolysis in Acute Stroke: Mechanical Thrombolytic Treatment Techniques, Stent Retriever Devices, Other...
While intravenous (IV) tissue-type plasminogen activator (tPA) had been the only medical therapy approved for treatment of acute stroke in the United States, four trials have now shown the efficacy of endovascular therapy, the most recent of which, SWIFT-PRIME, was presented at a plenary session of the International Stroke Conference in Nashv...
Western Pacific Region Index Medicus
Abstract: PURPOSE: 1) To identify the time taken from symptom onset to the arrival at the hospital (pre-hospital delay time) and time taken from the arrival at the hospital to the initiation of the major treatment (in-hospital delay time) 2) to examine whether rapid treatment results in lower mortality. 3) to examine whether the pre- and in-hospital delay time can independently predict in-hospital mortality. METHODS: A retrospective study with 586 consecutive AMI patients was conducted. RESULTS: Pre-hospital delay time was 5.25 (SD=10.36), and in-hospital delay time was 1.10 (SD=1.00) hours for the thrombolytic therapy and 50.24 (SD=121.18) hours for the percutaneous transluminal coronary angioplasty(PTCA). In-hospital mortality was the highest when the patients were treated between 4 to 48 hours after symptom onset using PTCA (rho=.02), and when treated between 30 minutes and one hour after hospital arrival using thrombolytics (rho=.01). Using a hierarchical logistic regression model, the pre- ...
Disclosures: Maximo C. Kiok, M.D. Medical Director of Stroke Program Trinity Health System. - ppt download
Overview of Treatment Options IV thrombolytic therapy (0-3 hrs) IV thrombolytic therapy (3-4.5 hrs) IA thrombolytic therapy Endovascular mechanical thrombectomy (Merci, Penumbra, Solitaire, etc.) Balloon angioplasty with stenting Anti-platelet agents for non-thrombolytic Rx Anticoagulants for atrial fibrillation
Study of Alfimeprase's Ability to Dissolve Blood Clots in the Leg and Help Prevent the Need for Surgery - Tabular View -...
There is an unmet medical need to improve thrombolytic therapy in acute peripheral arterial occlusion (PAO). Currently used plasminogen activators can result in increased circulating levels of plasmin that result in a systemic lytic state that does not distinguish between physiologic and pathologic thrombosis. In general, mean plasminogen activator infusion durations of greater than 24 hours in order to achieve successful thrombolysis are problematic in a disease where delayed restoration of arterial flow can lead to irreversible ischemic damage. A direct thrombolytic agent like alfimeprase, with a rapid mechanism of action and a potentially safer bleeding risk profile, could facilitate a rapid restoration of arterial flow and avoidance of open vascular surgery ...
Selection of Patients for Systemic Thrombolysis in Pulmonary Embolism (PE). Selecting the correct patient for systemic thrombolysis necessitates a thorough assessment of the patients preexisting comorbidities, mode of presentation and focused clinical examination to assess the immediate risk of hemodynamic collapse, the risk of long term complications, and the risk of major bleeding associated with the thrombolytic agent. As described above, high-risk PE patients warrant strong consideration of aggressive treatment options, including systemic thrombolysis with a high incidence of adverse outcomes if not instituted expediently. In patients who present with acute high-risk PE, the risk of mortality is high which makes the decision for systemic thrombolysis relatively easier as compared to the people who are hemodynamically stable. The case fatality of these hemodynamically unstable patients ranges from 35% to 58%. Therefore, benefits clearly outweigh the risk of adverse outcomes in the grand ...
Rapid Early Action for Coronary Treatment (REACT) - Full Text View - ClinicalTrials.gov
BACKGROUND:. Since the advent of thrombolytic therapy, early treatment holds particular promise for decreasing mortality from coronary heart disease. Thrombolytic therapy can reduce mortality by 25 percent for patients treated within the first few hours of AMI symptoms, with greater benefit the earlier the treatment. Not everyone who could benefit from receiving thrombolytic therapy receives such therapy. One contributing factor is that many people with symptoms do not seek emergency care in a timely manner. Studies show substantial delay times from AMI symptoms to hospital arrival, with means ranging from 4.6 to 24 hours and medians from 2 to 6.4 hours. EMS transport time is estimated to average 7 to 22 minutes, so a large portion of pre-hospital delay is attributable to patient recognition and action. Several factors have been associated with delay time. Sudden onset pain is associated with shorter delay times, and older age, female gender, African-American race, consultation with others about ...
Clinical Trials Registry | Internet Stroke Center
BACKGROUND: Thrombolytic drugs may dissolve blood vessel clots in acute ischemic stroke. The overall benefit of intravenous thrombolysis is substantial, but up to 2/3 of patients with large clots may not achieve re-opening of the vessel and up to 40% of the patients may remain severely disabled or die. Ultrasound accelerates clot break-up (lysis) when combined with thrombolysis (sonothrombolysis) and increases the likelihood of functional independence at 3 months. Adding intravenous ultrasound contrast (gaseous microspheres) further enhances the thrombolytic effect (contrast enhanced sonothrombolysis = CEST). Contrast enhanced ultrasound may also accelerate clot break-up in the absence of thrombolytic drugs (contrast enhanced sonolysis = CES ...
thrombolytic therapy implications for patient management
The purpose of this course is to increase clinicians knowledge of thrombolytic medications so that they can identify the optimal therapy and safely use these medications.
Cost-effectiveness of Perfusion Imaging With Computed Tomographyto Identify Patients for Intravenous Thrombolysis: A Hospital...
Jackson, D., Earnshaw, S., Farkouh, R. A., & Schwamm, L. H. (2010, May). Cost-effectiveness of Perfusion Imaging With Computed Tomography to Identify Patients for Intravenous Thrombolysis: A Hospital Perspective. Presented at ISPOR 15th Annual International Meeting, .. ...
How early one can shift a patient for rescue PCI after failed thrombolysis ? | Dr.S.Venkatesan MD
How early one can shift a patient for rescue PCI after failed thrombolysis ? Wait for at-least 24 hours. A minimum cool off period of 2 hours is required. It is never an issue . Rush the patient immediately to cath lab The question does not arise . Often times , rescue PCI is a…
Difference between revisions of Thrombolytics for STEMI - WikEM
Indications,ref,ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf,/ref,,ref,Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.,/ref ...
Thrombolytic Treatment Before Stenting Linked to Increased Mortality | Medpage Today
DALLAS - The use of thrombolytics before angioplasty or stenting offers no benefit and appears to increase the risk of heart attacks, strokes, or death.
The role of thrombolytic therapy for the treatment of pulmonary embolism has been unclear, as it has been difficult to measure the precise balance between enhanced clot-dissolving efficacy and greater bleeding risk produced by thrombolysis when compared with conventional anticoagulation. A new meta-analysis published in JAMA analyzed data from 16 randomized trials including 2115 patients. Overall, […]. ...
Intravenous thrombolysis in stroke after dabigatran reversal with idarucizumab: case series and systematic review | Journal of...
Contributors DG, SR and SC conceived the idea, planned and designed the study. DG, CC, AM and MR wrote the first draft. CM and AG evaluated and wrote the clinical cases. DG and SM designed the search strategy. DG, ES, AM and MR evaluated the literature and selected the papers. DG, SR and CC planned the data extraction. SM, AM and MR extracted and analysed data. DG and MR revised the draft and updated the manuscript. CP, SC, TM and SR provided critical insights. All authors have approved and contributed to the final version of the manuscript. ...
Heart-and-Stroke-Encyclopedia - 2010-06-03 - The Golden Hour and Acute Brain Ischemia: Presenting Features and Lytic Therapy in...
Blood vessel dilators, also called vasodilators, are drugs that cause the blood vessels (especially the arterioles) to expand in an effort to lower blood pressure and reduce the work of the heart in pumping blood. ACE inhibitors and nitroglycerine are examples of vasodilators.. ...
Bruno-Marcel Mackert | Vivantes
Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial. Ebinger M, Winter B, Wendt M, Weber JE, Waldschmidt C, Rozanski M, Kunz A, Koch P, Kellner PA, Gierhake D, Villringer K, Fiebach JB, Grittner U, Hartmann A, Mackert BM, Endres M, Audebert HJ; STEMO Consortium. JAMA. 2014 Apr 23-30;311(16):1622-31. doi: 10.1001/jama.2014.2850. PMID: ...
Is the time window for primary PCI different from thrombolysis ? | Dr.S.Venkatesan MD
Time is muscle .This may sound as an old fashioned statement now , for many of us. But the fact remains. Every minute following STEMI , myocytes keep losing its life one by one unless , the intervened. The prevention of myocyte death can be accomplished by three ways By early thrombolysis By Primary angioplasty…
Get PDF - Acute neonatal arterial occlusion: is thrombolysis safe and effective?
Ade-Ajayi, N.; Hall, N.J.; Liesner, R.; Kiely, E.M.; Pierro, A.; Roebuck, D.J.; Drake, D.P., 2008: Acute neonatal arterial occlusion: is thrombolysis safe and effective?
Early intravenous thrombolytic therapy for acute myocardial infarction in patients with prior coronary artery bypass grafts<...
TY - JOUR. T1 - Early intravenous thrombolytic therapy for acute myocardial infarction in patients with prior coronary artery bypass grafts. AU - Kleiman, Neal. AU - Berman, David A.. AU - Gaston, William R.. AU - Cashion, W. Richard. AU - Roberts, Robert. PY - 1989/1/1. Y1 - 1989/1/1. N2 - Treatment of acute myocardial infarction (AMI) with intravenous thrombolytic agents is gaining wide acceptance as a result of the demonstrated ability of fibrinolytic agents to restore coronary arterial patency,1 improve left ventricular function2-4 and reduce mortality.5,6 Most published trials have excluded patients with previous coronary artery bypass grafting, primarily because of difficulty in identifying the infarct-related coronary artery. However, the yearly rate of myocardial infarction is approximately 3% after coronary artery bypass surgery,7 and as the number of patients with bypass grafts increases and the population with bypass grafts in place ages, an increasing number of AMIs in this group can ...
Antithrombotic and thrombolytic therapy for ischemic stroke: The Seventh ACCP Conference on Antithrombotic and Thrombolytic...
TY - JOUR. T1 - Antithrombotic and thrombolytic therapy for ischemic stroke. T2 - The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. AU - Albers, Gregory W.. AU - Amarenco, Pierre. AU - Easton, J. Donald. AU - Sacco, Ralph L. AU - Teal, Philip. PY - 2004/9/1. Y1 - 2004/9/1. N2 - This chapter about treatment and prevention of stroke is part of the 7th ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the benefits do, or do not, outweigh risks, burden, and costs. Grade 2 suggests that individual patients values may lead to different choices (for a full understanding of the grading see Guyatt et al). Among the key recommendations in this chapter are the following: For patients with acute ischemic stroke (AIS), we recommend administration of IV tissue plasminogen activator (tPA), if treatment is initiated within 3 h of clearly defined symptom onset (Grade 1A). For patients with extensive ...
Thrombolytic treatment of acute ischemic stroke<...
TY - JOUR. T1 - Thrombolytic treatment of acute ischemic stroke. AU - Meschia, James F. AU - Miller, David A.. AU - Brott, Thomas G. PY - 2002. Y1 - 2002. N2 - Intravenous recombinant tissue-type plasminogen activator is approved by the US Food and Drug Administration for treating acute ischemic stroke within 3 hours of onset of symptoms. Initiation of thrombolysis within 90 minutes of onset of symptoms is a treatment goal supported by current studies. Postmarketing data suggest that the risk of intracranial hemorrhage may be unacceptably high when recombinant tissue-type plasminogen activator is given to patients who would not have been eligible for enrollment in the pivotal phase 3 clinical trials. Further studies of local intra-arterial thrombolysis and improved selection of patients with advanced brain imaging are expected in the future, but the emphasis at present should be on rapid identification, evaluation, and treatment of appropriate patients with intravenous therapy.. AB - Intravenous ...
Catheter-Directed Thrombolysis for Pulmonary Embolism | JACC: Cardiovascular Interventions
There have been 2 main treatments for acute pulmonary embolism (PE)-anticoagulant therapy alone or systemic thrombolytic therapy. Although systemic thrombolytic therapy is effective at preventing deaths from PE, it markedly increases bleeding, including intracranial and fatal bleeding (1). The recent PEITHO (Pulmonary Embolism Thrombolysis Study) (2), which compared tenecteplase with placebo in 1,000 PE patients without hypotension but with right ventricular dysfunction, found no clear net benefit from systemic thrombolytic therapy; the reduction in cardiovascular collapse (odds ratio: 0.30) was offset by the increase in major bleeding (odds ratio: 5.2). Consequently, systemic thrombolytic therapy is usually reserved for PE patients with hypotension (3). The ability to actively remove thrombus in patients with acute PE without increasing bleeding would be an important advance. Catheter-based therapy has that potential.. Catheter-directed thrombolysis (CDT) was initially developed for treatment ...
1995 - Streptokinase led to higher 10-day and 6-month case fatality rates in acute stroke | 1996 May-Jun : Volume 124...
The MAST-I study arguably has generated the least discussion of the 3 large trials that published formal reports about intravenous thrombolytic therapy in acute stroke. Based on the positive findings of the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study (1) and the neutral but encouraging results of the European Cooperative Acute Stroke Study (ECASS) (2), the notion has gained momentum that the time for the use of intravenous thrombolysis is at hand. Although published almost simultaneously with the NINDS rt-PA Study, MAST-I imparts a different message. This study showed that intravenous thrombolysis was too dangerous in the short term (within 10 days of starting treatment) to provide a statistically significant net benefit in the long term. The logical question that arises is whether intravenous thrombolysis for stroke will resemble the results from the NINDS rt-PA Study or MAST-I in the real world. The design features of MAST-I may be the source of the ...
Percutaneous treatment of failed native dialysis fistulas: use of pulse-spray pharmacomechanical thrombolysis as the primary...
To determine the efficacy and outcome of percutaneous treatment in restoring the function of failed native arteriovenous fistulas (AVFs) where pulse-spray pharmacomechanical thrombolysis was used as the primary mode of therapy. From June 2001 t
Cell permeable HMGB1-binding heptamer peptide ameliorates neurovascular complications associated with thrombolytic therapy in...
Blood-brain barrier (BBB) breakdown and inflammatory responses are the major causes of tissue-type plasminogen activator (tPA)-induced hemorrhagic transformation (HT), while high-mobility group box 1 (HMGB1) exacerbates inflammatory damage to BBB during the process of brain ischemia/reperfusion. This study aimed to investigate the change of HMGB1 after thrombolytic therapy and whether blocking HMGB1 could ameliorate the neurovasculature complications secondary to tPA treatment in stroke rats. Sera from acute stroke patients and rats with thrombolytic therapy were collected to investigate HMGB1 secretion. Male Sprague-Dawley rats with 2 h or 4.5 h middle cerebral artery occlusion were continuously infused with tPA followed by administration of membrane permeable HMGB1-binding heptamer peptide (HBHP). The mortality rate, neurological score, HT, brain swelling, BBB permeability, and inflammatory factors were determined. The results revealed that HMGB1 levels were elevated in both stroke patients and rats
Questionnaire survey of thrombolytic treatment in accident and emergency departments in the United Kingdom | The BMJ
Numerous randomised trials have shown that thrombolytic treatment reduces mortality from acute myocardial infarction irrespective of the patients age, sex, blood pressure, and previous history of myocardial infarction or diabetes.1 Maximum benefit, however, is seen in those patients treated within 4-6 hours of their symptoms starting. Patients do not always seek medical help soon enough, and this accounts for much of the delay in receiving thrombolytic treatment, but important delays also occur in hospital. These are not related to the route by which the patient is admitted to hospital and vary widely between hospitals.2. Although accident and emergency departments are in an important position to minimise any delay in giving thrombolytic treatment, a recent questionnaire study of junior hospital doctors in Scotland showed that thrombolysis is rarely given in accident and emergency departments there.3 We surveyed consultants in accident and emergency departments … ...
Thrombolytic therapy for acute ischemic stroke - Eesti Arst - Eesti Arstide Liidu ajakiri
The main goal of thrombolysis is to restore the bloodflow in the ischemic area of the brain and to stop the neuronal ischemic cascade damaging the neurons and to prevent their premature death. All the thrombolytic agents are the activators of plasminogen, which convert the proenzyme plasminogen to plasmin. The plasmin destroys the most important component of the thrombus - the fibrin an therefore causing the whole thrombus to dissolve. The thrombolytic agents studied include streptokinase, urokinase, recombinant pro-urokinase and recombinant tissue plasminogen activator (rt-PA). The three big clinical studies of streptokinase in acute ischemic stroke were disrupted due to negative results: the risk of intraparenhymal hemorrhages and death was signifficantly higher in treatment group vs placebo, the functional recovery was not improved with therapy. The results from clinical studies with urokinase were not so negative, but they were not finished after all. Only the rt-PA, synthesised in 1980s, ...
Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism | Circulation
The currently available randomized data provide no evidence of benefit of thrombolytic therapy compared with heparin for the initial treatment of unselected patients with acute pulmonary embolism. However, subgroup analyses indicate a benefit of thrombolysis compared with heparin in trials that included patients with major pulmonary embolism but no benefit in trials that excluded these patients. This apparent heterogeneity of treatment effect appears to be due to an effect of thrombolytic therapy on death, the incidence of which was approximately 5-fold higher in heparin-treated patients enrolled in trials that also included patients with major pulmonary embolism. Patients at risk of dying of major pulmonary embolism are also those most likely to achieve benefit from thrombolytic therapy, because more rapid clot lysis can reverse hypotension and prevent irreversible shock that leads to death.. Registry data indicate that right ventricular dysfunction in patients with acute pulmonary embolism is ...
Is prehospital thrombolysis for acute myocardial infarction warranted in the urban setting? The case against | Emergency...
This paper forms the second part of the debate on prehospital thrombolysis (PHT). It is argued that large scale studies have failed to show a benefit for PHT, even when the time saved over conventional treatment was considerably greater than would be the case in the UK urban setting. In practice, a relatively small proportion of the total population receiving thrombolysis would receive PHT. Other strategies to reduce time to thrombolysis can benefit all patients and are likely to be more cost effective and safer.. ...
A Case Report of Atrial Myxoma presenting with Cardioembolic Stroke and treated with Intravenous Thrombolytic Therapy | Journal...
This retrospective review of 17 patients suggests an increased risk of adverse events including premature death with opiate discontinuation long after withdrawal stage.
Higher Annual Operator Volume Is Associated With Better Reperfusion Rates in Stroke Patients Treated by Mechanical Thrombectomy...
Our large multicenter real-world MT cohort, including 1,541 consecutive patients with anterior and posterior AIS documented the correlation between higher operator volume and successful reperfusion rate, with an ICC of 0.037 (p = 0.046), but not on complications. We observed a dose-response relationship between annual operator volume and successful reperfusion (p = 0.003). This finding is in line with previous studies in other interventions. For example, characteristics of operators such as volume of procedures per year and number of years of practice have been found to be an independent clinical and radiological outcome predictor in interventional cardiology for myocardial infarction syndromes in several studies (8,9,13,14). Moreover, several studies, such as the CAPTURE 2 (Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events), analyzing the association of the physician variables and outcomes in carotid artery stenting, showed that one of the most important determinants of ...
Assessment of neurologists knowledge regarding intravenous fibrinolytic therapy for acute stroke in Shanxi province in China |...
Thrombolytic therapy is of proven and substantial benefit for select patients with acute cerebral ischemia. Nevertheless, currently there is a low rate of fibrinolytic therapy in China. Therefore, in this study, the objective was to explain the reasons for the low rate of fibrinolytic therapy from the perspective of physicians knowledge in Shanxi Province, P. R. China. A similar study has not been performed previously in China. The current study indicated that the neurologists were knowledge deficient in the area of intravenous fibrinolytic therapy for acute ischemic stroke. This partially accounts for the low rate of fibrinolytic therapy in China.. Here, it was showed that the accuracy rates of 12 questions pertaining to physicians knowledge in this area displayed a broad range (from 0.8 to 96.2%). The accuracy rates of half of all questions were lower than 60%. In general, these neurologists displayed the most optimal scores in the areas of CT imaging criteria of thrombolysis and necessary ...
Get PDF - Long term follow up after thrombolytic therapy
Lotan, C.; Gurevitch, J.; Mosseri, M.; Weiss, A.T.; Sapoznikov, D.; Rosenheck, S.; Admon, D.; Gotsman, M.S., 1987: Long term follow up after thrombolytic therapy
Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and...
TY - JOUR. T1 - Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and clinical outcomes following thrombolytic administration in acute myocardial infarction. AU - Michael Gibson, C.. AU - Kirtane, Ajay J.. AU - Murphy, Sabina A.. AU - Marble, Susan J.. AU - de Lemos, James A. AU - Antman, Elliot M.. AU - Braunwald, Eugene. PY - 2001/5/16. Y1 - 2001/5/16. N2 - The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of ...
Timeliness of Intravenous Thrombolysis via Telestroke in Georgia | National Minority Quality Forum a not-for-profit...
Methods-We retrospectively analyzed 115 records of consecutive acute stroke patients treated with intravenous thrombolysis during a 20-month period via a statewide telestroke system in 17 EDs in Georgia. On the basis of times documented in the telestroke system, we calculated the time elapsed between the following events: ED arrival, telestroke patient registration, start of specialist consultation, head computed tomography, thrombolysis recommendation, and thrombolysis initiation. Read More. ...
The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction : a subgroup analysis of the...
AIMS: No antithrombotic therapy has been shown to reduce mortality when used with thrombolytics in acute myocardial infarction (AMI). In the OASIS-6 trial, fondaparinux significantly reduced mortality and reinfarction without increasing bleeding in 12 092 patients with acute ST elevation MI. METHODS AND RESULTS: We report the results of a subgroup analysis in the 5436 patients (45%) receiving thrombolytics. According to local practice, 4415 patients did not have an indication for unfractionated heparin (stratum 1) and 1021 did (stratum 2). Fondaparinux reduced the primary study outcome of death or MI at 30 days [Hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.68-0.92] with consistent reductions in both mortality (HR and CI) and reinfarction (HR and CI). There was a non-significantly lower rate of stroke (HR 0.77, CI 0.48-1.25). The risk of severe bleeding was significantly reduced (HR 0.62, CI 0.40-0.94), and thus the balance of benefit and risk (death, MI and severe haemorrhage) was ...
Intravenous Thrombolysis for Ischemic Stroke Patients on Dual Antiplatelets<...
TY - JOUR. T1 - Intravenous Thrombolysis for Ischemic Stroke Patients on Dual Antiplatelets. AU - Tsivgoulis, Georgios. AU - Katsanos, Aristeidis H.. AU - Mavridis, Dimitris. AU - Gdovinova, Zuzana. AU - Karlinski, Michal. AU - Macleod, Mary Joan. AU - Strbian, Daniel. AU - Ahmed , Niaz N1 - We thank all SITS-ISTR investigators and their centers for their participation. We also pass on our thanks to all patients who participated in SITS-ISTR. The current SITS registry is developed, maintained and upgraded by Zitelab, Copenhagen, Denmark, in close collaboration with SITS. SITS (Safe Implementation of Treatment in Stroke) is financed directly and indirectly by grants from Karolinska Institute, Stockholm County Council, the Swedish Heart-Lung Foundation, the Swedish Order of St. John, Friends of Karolinska Institute, and private donors, as well as from an unrestricted sponsorship from Boehringer-Ingelheim. SITS has previously received grants from the European Union Framework 7, the European Union ...
Tips From Other Journals - American Family Physician
Previous studies of interventions in acute myocardial infarction (MI) have attempted to determine which intervention is better, thrombolytic agents or angioplasty. One possible alternative would be to use both interventions in patients with acute MI. Some small studies have raised the concern that thrombolytic use before angioplasty would significantly increase the risk of bleeding. Ross and colleagues studied the safety and effectiveness of using a short-acting thrombolytic agent followed by angioplasty in patients with acute MI.. Patients who met the criteria for acute MI were eligible for the study. All of these patients received aspirin and heparin therapy before the start of the study interventions. They were then randomized to receive a 50-mg bolus of recombinant tissue-type plasminogen activator (rt-PA) or placebo. The half-life of rt-PA is 4.5 minutes. All patients were then studied by coronary angiography followed immediately by angioplasty if it was indicated. Outcome measures were ...
1993 - Late thrombolysis improved survival only if given within 12 hours of onset of acute myocardial infarction...
Late thrombolysis did not improve survival in suspected acute myocardial infarction. At least 30% of patients with acute MI admitted to hospitals (participating in thrombolytic trials) are excluded from receiving thrombolysis because of symptom duration , 6 hours. Some clinicians do not treat patients beyond the 3- or 4-hour limit within which myocardial salvage can be achieved. Yet, increasing data suggest that mortality reduction caused by mechanisms other than myocardial salvage can occur for hours after symptom onset if infarction artery patency can be restored. Limitation of left ventricular dilatation and aneurysm formation, improved healing, better electrical stability, reduced mural thrombus formation, and potential collateral circulation to a remote ischemic zone are possible mechanisms that collectively constitute the open artery hypothesis. The traditional 6-hour time window for thrombolytic benefit originated from the statistical analysis of the Gruppo Italiano per lo Studio della ...
Thrombolytic treatment in stroke mimic, inevitable but fortunately safe: An observational study from Iran
Background: A number of patients with symptoms of acute cerebral ischemia may have other causes called stroke mimics (SM). The prevalence of SM can be as high as 31% in some reports, and these patients are potentially at the risk of intravenous thrombolysis (IVT) therapy and its complications. This study was designed to determine the prevalence of our center s SM among patients who received IVT, their baseline characteristics, final diagnoses, and outcomes. Methods: We reviewed the medical records of all patients who received IVT between June 2015 and November 2017. The following variables were collected: demographic characteristics, past medical history, onset-to-needle (OTN) time, door-to-needle (DTN) time, National Institutes of Health Stroke Scale (NIHSS) score at admission, brain imaging, and all paraclinic findings. Functional outcome at discharge based on modified Rankin Scale (mRS) was also assessed. Results: 12 out of 165 (7.1%) patients including 8 men and 4 women were finally diagnosed
Stenting versus thrombolysis in acute myocardial infarction trial (STAT).
OBJECTIVES: We sought to directly compare primary stenting with accelerated tissue plasminogen activator (t-PA) in patients presenting with acute ST-elevation myocardial infarction (AMI). BACKGROUND: Thrombolysis remains the standard therapy for AMI.
Most recent papers with the keyword Thrombolytic therapy | Read by QxMD
Pulmonary embolism (PE) represents a prevalent cause of morbidity and mortality in the United States, with approximately 600 000 cases diagnosed annually. The mortality rate for untreated PE is as high as 30%. Right ventricular (RV) dysfunction is a sign of possible adverse outcomes with right-sided heart failure being the usual cause of death from PE. There is a spectrum of clinical presentations associated with PE diagnoses, from incidental and asymptomatic to rapid hemodynamic collapse. Despite successes in identifying patients with high-risk PEs for aggressive thrombolytic interventions and low-risk PEs for outpatient anticoagulation, a significant lack of consensus exists regarding intervention modalities for PEs identified as intermediate risk or submassive, defined as normotensive (systolic blood pressure ≥90 mm Hg) with acute RV dysfunction and myocardial injury ...
Economic impact of using additional diagnostic tests to better select patients with stroke for intravenous thrombolysis in the...
BACKGROUND: Eligibility for thrombolysis as an acute stroke treatment is determined through the use of unenhanced noncontrast computed tomography (CT), time since stroke onset, and patient history. Assessing penumbral patterns, which can be examined only through the use of diagnostic technologies such as magnetic resonance imaging (MRI) and perfusion CT (CTP), may be able to better select patients for thrombolysis. However, trade-offs in terms of administration time and cost may affect the value of using these diagnostic studies. OBJECTIVE: We examined the trade-offs among patient selection via usual care with CT, usual care plus MRI using diffusion-weighted and perfusion imaging, and usual care plus CTP for their effect on costs and outcomes when diagnosing stroke and selecting candidates for thrombolysis in the United Kingdom. METHODS: A decision-analytic model was developed. Efficacy and utilities were obtained from published studies. Costs were obtained from standard UK costing sources and ...
T-cell recognition of discrete regions of the thrombolytic drug streptokinase | Clinical Science
Streptokinase (SK) is a bacterial protein used clinically as a thrombolytic agent in humans. Administration of SK causes a rapid increase in the frequency of anti-SK T cells and the titre of specific anti-SK antibodies that, on subsequent administration of SK, may neutralize the activity of the drug or elicit allergic-type reactions. By locating and modifying the immunogenic T-cell epitopes within the SK protein, it is possible that an agent with reduced immunogenicity but equal efficacy may be produced. We have investigated the T-cell epitopes within SK using nine non-overlapping, recombinant peptide fragments of SK. We investigated the proliferative T-cell response of peripheral blood mononuclear cells obtained from patients before and 6 days after administration of SK for myocardial infarction. We also examined the response of cultured anti-SK T-cell lines derived from patients 6 days after treatment with SK. Before administration of SK, peripheral blood mononuclear cells from six of nine ...
STElevation Myocardial Infarction Thrombolytic Therapy - Myocardial Infarction
While aggressive reperfusion therapy with pharmacologic agents has been shown to reduce in-hospital mortality by as much as 25-30 , women are more likely to
Pilot and Preliminary Studies of Thrombolytic Therapy for Stroke | Springer for Research & Development
The demonstration that tissue plasminogen activator (t-PA) is clinically effective for acute ischemic stroke was based on many important studies over the past two decades that then led to...
Dr. Smiths ECG Blog: Chest Pain and Cardiogenic Shock with Profound ST Depression & STE in aVR. Activate the Cath Lab?
3) Fibinolytic therapy! When managing this patient, I kept this option in mind. Fibrinolytics have long been forbidden for ST depression, but this is based on very sketchy data from the thrombolytic era. In a nutshell, in those randomized trials, the patients enrolled had 1) few lead with ST depression, 2) very minimal ST depression and 3) were treated, depending on the study, at 6-12 hours after onset, a time at which most myocardium at risk may already be irreversibly infarcted. Thus, the ACC/AHA 2013 STEMI guidelines now list diffuse ST depression, with ST elevation in aVR, as an indication for thrombolytic therapy. I discuss this more at this post ...
THROMBOLYTICS TO AID CLOT LYSIS IN INTRACEREBRAL HAEMORRHAGE: IDENTIFYING STRATEGIES TO MAXIMISE BENEFIT | Research Explorer |...
Intracerebral haemorrhage (ICH) is a subtype of stroke caused by bleeding into the brain. ICH has a high case fatality rate of 42% at 1 month and only 20% of survivors regain independence. Large clinical trials are currently underway to assess the potential benefit of minimally invasive surgery (MIS) in combination with the thrombolytic alteplase in ICH. Although preliminary results are promising alteplase is known to be neurotoxic and may therefore exacerbate damage when administered in ICH, reducing its overall effectiveness. Alternative thrombolytics to alteplase do exist and the initial aim of this project is to establish the toxicity of these compounds in comparison with alteplase in cell culture. Here the optimisation of a cell culture model of neuronal injury is described. This utilizes a glial-neuronal rat cortical co-culture with 5μM of FUDR added during seeding. After 12 days of culture cells are treated with the pro-inflammatory cytokine interleukin-1β as a full media change with ...
Clinical Trials Registry | Internet Stroke Center
Acute stroke is the third leading cause of mortality in developed countries and the major medical cause of disability in adults. The outcome can be improved by early treatment with thrombolysis. Alteplase (r-tPA) is the only approved thrombolytic drug in the indication of acute ischemic stroke. However, the use of alteplase is currently restricted by the need to administer it within 3 hours of symptom onset. As the risk of transforming a cerebral infarct into haemorrhage probably rises as the time elapsed increases, a thrombolytic drug that carries a lower risk of haemorrhage than alteplase may offer a wider time-to-treatment window and improve the safety profile ...
Thrombolysis in cerebral infarction (TICI) scale | Radiology Reference Article | Radiopaedia.org
The thrombolysis in cerebral infarction (TICI) grading system was described in 2003 by Higashida et al. 1 as a tool for determining the response of thrombolytic therapy for ischaemic stroke. In neurointerventional radiology it is commonly used fo...
Successful treatment of an acute sub-massive pulmonary embolism in a renal transplant patient with thrombolytic of low dosage...
Successful treatment of an acute sub-massive pulmonary embolism in a renal transplant patient with thrombolytic of low dosage in low infusion protocol, Aysel Akhundova, Kenan Sonme
24-7 Drugstore: Suplement recover from propecia lowest price guaranteed!
London, the multidisciplinary team of suplement recover from propecia physicians. It might progress to invasive scc ver- rucous and low-grade nuclei b. Acute suppurative inammation in myositis a high booking bp, who may use force to the consequences of treatment with high-dose steroids and either oral or injection immediately if an ace inhibitor therapy to help develop the condition include: Pain; soft tissue appearances of cin and patient demographics. Not to be activated. The revised nice guidelines, a second abnormal result azoospermia or genetic defects and headaches, or due to reduced gonadotrophin secretion and signs associated with a calculator, and for cancer. Liquids with high dose mg day or low-dose clonazepam at night. Moreover, with increased risk in the rst principal component equations the following thrombolytic agents. Pathophysiology mri: Some have I insensible losses. Patients should be sought if antibacterials are required to reverse back to colposcopy abnormal glandular ...
Ischemic stroke is a very frequent neurological disorder. Its incidence is increasing as western societies are aging. Effective therapies that reduce mortality and increase the chances of living symptom-free or, at least, in independence are available. Intravenous or intraarterial thrombolysis is an effective treatment with a number needed to treat of 6 if given within 4.5 hours after symptom onset. The safe use of thrombolysis requires an effective and repeatedly trained workflow established within a team of a neurologist and specialized nursing staff in an optimized environment (admission, imaging facility, laboratory, stroke unit). After peracute treatment, the patient should be transferred to a stroke unit. This unit is a spatially defined intermediate care unit with specifically trained personnel (physicians, nurses, therapists). Treating the patient in a stroke unit is as effective in improving outcome as thrombolysis and also reduces the length of hospital stay. In contrast to ...
Acute Myocardial Infarction (AMI) Sapulpa OK - Acute myocardial infarction, Sapulpa OK AMI, Sapulpa OK MI, Sapulpa OK heart...
Looking for information on Acute Myocardial Infarction (AMI) in Sapulpa? We have compiled a list of businesses and services around Sapulpa that should help you with your search. We hope this page helps you find information on Acute Myocardial Infarction (AMI) in Sapulpa.
Proteases (medical and related uses)
Rivera-Bou WL, Cabanas JG, Villanueva SE (2008-11-20). "Thrombolytic Therapy". Medscape. Wardlaw JM, Murray V, Berge E, del ... Maggot therapy for wound debridement is a traditional therapy which was in recent years approved by the FDA. It has been ... See article Maggot therapy -- Regulation and references cited therein. Reames MK, Christensen C, Luce EA (October 1988). "The ... It is one of the enzymes in Sollpura (Liprotamase), a pancreatic enzyme replacement therapy (PERT). It assists in the break ...
Tissue plasminogen activator
"Thrombolytic Therapy: Background, Thrombolytic Agents, Thrombolytic Therapy for Acute Myocardial Infarction". Medscape. Tsurupa ... Rivera-Bou WL, Cabanas JG, Villanueva SE (2008-11-20). "Thrombolytic Therapy". Medscape. Wardlaw JM, Murray V, Berge E, del ... "Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy". Archives of Surgery. 142 (6): 546-51, ... with one resulting in desired thrombolytic activity (see figure). For starters, following administration and release, tPA can ...
Rivera-Bou WL (15 December 2016). "Thrombolytic Therapy". MedScape. Retrieved 28 February 2017. Law RH, Caradoc-Davies T, ... resulting in an increased capacity to treat thrombolytic diseases. Urokinase is similarly used in the medical field, ...
Thrombolytic therapy: This is a treatment used to break up masses of plaque inside the arteries via intravenous clot-dissolving ... MedlinePlus Encyclopedia: Thrombolytic therapy "Atherosclerosis". Merck Manuals. Retrieved 13 February 2015. Mayerl, Christina ... Medical therapy is often prescribed to help prevent arteriosclerosis for underlying conditions, such as medications for the ...
Nakamura S, Takano H, Kubota Y, Asai K, Shimizu W (July 2014). "Impact of the efficacy of thrombolytic therapy on the mortality ... Zuo, Zhiliang; Yue, Jirong; Dong, Bi Rong; Wu, Taixiang; Liu, Guan J.; Hao, Qiukui (2021-04-15). "Thrombolytic therapy for ... Ucar, Elif Yilmazel (June 2019). "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism". The Eurasian Journal of ... transgender hormone therapy, menopausal hormone therapy and hormonal contraceptives) Genetic thrombophilia (factor V Leiden, ...
Intra-aortic balloon pump
Thrombolytic therapy of acute myocardial infarction. The following conditions will always exclude patients for treatment: ... The patient, a 48-year-old woman, was in cardiogenic shock and unresponsive to traditional therapy. An IABP was inserted by a ... Aortic dissection Severe aortoiliac occlusive disease and bilateral carotid stenosis The following conditions make IABP therapy ...
Harbans Singh Wasir
Shyam Sunder Kothari; Sudhir Varma; Harbans Singh Wasir (March 1994). "Thrombolytic therapy in infants and children". American ... Shyam Sunder Kothari; Sudhir Varma; Harbans Singh Wasir (March 1994). "Thrombolytic therapy in infants and children". American ...
Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an ... Wechsler LR (2011). "Intravenous thrombolytic therapy for acute ischemic stroke". N Engl J Med. 364 (22): 2138-46. doi:10.1056/ ... Anaphylaxis generally requires immediate cessation of thrombolysis. Thrombolysis therapy uses thrombolytic ... In people who receive thrombolytic therapy delivered through a catheter, there is a risk of hemorrhage as a side effect. ...
Thrombolytic therapy has become the treatment of choice. Surgical or catheter embolectomy is normally performed in patients ... for patients with persisting shock despite supportive care and who have an absolute contraindication for thrombolytic therapy. ...
... rethrombosis after thrombolytic therapy and rethrombosis after vascular surgery. It is also indicated for the prevention of ... Platelet counts and survival time remain normal during ancrod therapy. Ancrod was originally isolated from the venom of the ... and facilitates physical and ergo therapy. Finally, ancrod decreases the likelihood of local thrombotic events. These ...
John A. Ambrose
"Adjunctive thrombolytic therapy during angioplasty for ischemic rest angina. Results of the TAUSA Trial. TAUSA Investigators. ...
Laffel, Glenn; Braunwald, Eugene (1986). "Management of the Residual Stenosis following Thrombolytic Therapy of Acute ...
"Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy". Archives of Surgery. 142 (6): 546-51. ... Evidence is insufficient to determine whether or not hyperbaric oxygen therapy as an adjunctive treatment can assist in tissue ... Weaver LK, Greenway L, Elliot CG (1988). "Controlled Frostbite Injury to Mice: Outcome of Hyperbaric Oxygen Therapy". J. ... "Delayed treatment of frostbite injury with hyperbaric oxygen therapy: a case report". Aviat Space Environ Med. 73 (4): 392-4. ...
If diagnosed within 12 hours of the initial episode (attack) then thrombolytic therapy is initiated. An ... September 2004). "Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy ... Treatment varies between therapy and surgical intervention by the use of shunts. Portal vein thrombosis affects the hepatic ... Hence, protective therapies are required to attenuate IRI alongside reperfusion in acute ischemic conditions to improve ...
Thrombolytic therapy to abort a myocardial infarction is not always effective. The degree of effectiveness of a thrombolytic ... Thrombolytic therapy is indicated for the treatment of STEMI - if it can begin within 12 hours of the onset of symptoms, and ... 2002). "Thrombolytic therapy vs primary percutaneous coronary intervention for myocardial infarction in patients presenting to ... The benefit of prompt, primary angioplasty over thrombolytic therapy for acute STEMI is now well established. When performed ...
Treatment of established arterial thrombosis includes the use of antiplatelet drugs and thrombolytic therapy. Antiplatelet ... Antiplatlet therapy may increase the risk of a bleed during surgery, however, stopping therapy may increase the risk of other ... Antiplatelet therapy with one or more of these drugs decreases the ability of blood clots to form by interfering with the ... The same review found that continuing or discontinuing therapy also did not have a big difference on the incidence of bleeds ...
Discovery and development of direct thrombin inhibitors
"Heparin and Low-Molecular-Weight Heparin The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest. 126 (3 ... Anticoagulation therapy has a long history. In 1884 John Berry Haycraft described a substance found in the saliva of leeches, ... Before the use of DTIs the therapy and prophylaxis for anticoagulation had stayed the same for over 50 years with the use of ... which returned to baseline after cessation of therapy. Development of other oral DTIs, such as Sofigatran from Mitsubishi ...
... the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest. 126 (3 Suppl): 188S-203S. doi:10.1378/chest. ... Principles of Antithrombotic Therapy". In Lichtman MA, Beutler E, Kipps TJ, et al. (eds.). Williams Hematology (7th ed.). ISBN ... The hyperkalemia can appear within a few days after the onset of heparin therapy. More rarely, the side-effects alopecia and ... Segura MM, Kamen A, Trudel P, Garnier A (May 2005). "A novel purification strategy for retrovirus gene therapy vectors using ...
Treatment for thrombotic storm may include lifelong anticoagulation therapy and/or thrombolytic therapy, plasmapheresis, and ... Studies have shown that when anticoagulant therapy is withheld, recurrence of thrombosis usually follows. International ...
Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians Evidence-Based Clinical ... 2004; 110: 744-9. Dong B, Jirong Y, Liu G, Wang Q, Wu T. Thrombolytic therapy for pulmonary embolism. Cochrane Database Syst ... 1985; 312: 932-6. Sheehan FH et al., The effect of intravenous thrombolytic therapy on left ventricular function: a report on ... However, because access to invasive facilities is limited in many countries, thrombolytic therapy is still employed in many ...
Management of acute coronary syndrome
Some Paramedic services are capable of providing thrombolytic therapy in the prehospital setting, allowing reperfusion of the ... and reperfusion therapy is more often reserved for them. Long-term therapy is necessary for prevention of recurrent events and ... Medical therapy for acute coronary syndromes is based on drugs that act against ischemia and resultant angina and limit the ... Patients at low risk can be adequately treated with medical therapy, in many ways similar to the one used for STEMI (but ...
... thrombolytic drugs were introduced in the therapy of cerebral infarction. The use of intravenous rtPA therapy can be advocated ... cognitive therapy, occupational therapy, speech therapy and exercise. Permissive hypertension - allowing for higher than normal ... If cerebral infarction is caused by a thrombus occluding blood flow to an artery supplying the brain, definitive therapy is ... the best course of action is to make every effort to restore impairments through physical therapy, ...
L. Royal Christensen
Described as thrombolytic therapy, this treatment was named as one of the top 10 discoveries in cardiology in the 20th century ...
Gundu Hirisave Rama Rao
2007, ISBN 81-8061-936-2 Rao, GHR: (Editor): Clinical Handbook of Management of Antithrombotic & Thrombolytic Therapy. ...
February 2008). "The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction: a subgroup ...
Peter H. Lin
... in endovascular intervention in part contributed to the clinical approval of treatment indication using thrombolytic therapy in ... His clinical interests primarily involve minimally invasive endovascular therapy of deep vein thrombosis, peripheral arterial ... experimental models of endovascular therapy, and thrombolysis in arterial and venous thrombosis research. Lin's research ... Perspectives in Vascular Surgery and Endovascular Therapy. 22 (3): 171-182. doi:10.1177/1531003510379880. PMID 21098498. Lin, P ...
A large clinical trial of thrombolytic therapy for MI (GUSTO-1) evaluated the electrocardiographic diagnosis of evolving MI in ... Insights from the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT 2 and 3) trials". American Heart Journal ...
Anterior cerebral artery syndrome
... as contraindications to thrombolytic therapy should undergo rapid assessment. Cardiac sources of embolism can be evaluated as ... Dual antiplatelet therapy (aspirin and clopidogrel) are recommended to start within 24 hours for 21 days in patients with minor ... Antiplatelet therapy or anticoagulants are not recommended within 24h after alteplase administration. Aspirin is not a ... The CHANCE trial showed that the primary outcome of recurrent stroke at 90 days favored dual antiplatelet therapy over Aspirin ...
If the myocardial infarction is treated with thrombolytic therapy, the mortality increases to over 70%, mostly due to bleeding ... These individuals have been self-selected as survivors of the acute episode and can be treated with medical therapy as long as ... Complicated Stanford type B aortic dissections require surgical intervention after initiation of medical therapy.[citation ...
Percutaneous coronary intervention
... but this is less than the risk of a stroke following thrombolytic drug therapy. As with any procedure involving the heart, ... 85% of patients in the medical therapy arm elected to have PCI at the end of the trial. The 2019 ISCHEMIA trial has confirmed ... The length of time a patient needs to be on dual antiplatelet therapy is individualized based risks of ischemic events and ... The study compared stenting as used in PCI to medical therapy alone in symptomatic stable coronary artery disease (CAD). This ...
Morgan, Jay K.; Sadasivan, Balaji; Ausman, James I.; Mehta, Bharat (January 1990), "Thrombolytic therapy and posterior ...
List of Ig Nobel Prize winners
Schröder, Arjan E.; Vulink, Nienke C.; van Loon, Arnoud J.; Denys, Damiaan A. (1 August 2017). "Cognitive behavioral therapy is ... Investigators, T. G. (1993). "An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial ... Behaviour Research and Therapy. 45 (5): 977-987. doi:10.1016/j.brat.2006.07.009. PMID 16989773. Stephens, R.; Atkins, J.; ... for his determined use of electroshock therapy. At his own insistence, automobile spark plug wires were attached to his lip, ...
Management of atrial fibrillation
Conference on Antithrombotic and Thrombolytic Therapy recommends initiating warfarin without heparin bridging. While there is a ... Onalan O, Crystal E, Daoulah A, Lau C, Crystal A, Lashevsky I (2007). "Meta-analysis of magnesium therapy for the acute ... A trial comparing closure against warfarin therapy found closure to be non-inferior when measured against a composite end point ... 2008). "Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice ...
... is treated by removing the cause and giving supportive therapy; statin drugs have been found to improve ... cholesterol embolism may develop after the commencement of anticoagulants or thrombolytic medication that decrease blood ...
... 2A compared the results of 3 strategies of coronary angiography and angioplasty following intravenous thrombolytic therapy ... standard-dose prophylactic anticoagulation and antiplatelet therapy vs. no antiplatelet therapy on the risk of venous or ... ENTIRE-TIMI 23 assessed the safety and efficacy of enoxaparin as an adjunct to thrombolysis with or without GP IIb/IIIa therapy ... evaluated the benefit of abciximab bolus plus 12 hour infusion alone or in conjunction with reduced dose thrombolytic therapy ...
Vertebral artery dissection
The thrombolytic drug is administered either intravenously or during cerebral angiography through a catheter directly into the ... Anticoagulation is regarded as more powerful than antiplatelet therapy, but anticoagulants may increase the size of the ... "endovascular therapy" (inside the blood vessel). This may be performed to allow the blood to flow through a severely narrowed ... "Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From ...
In this family, dextran-40 (MW: 40,000 Da), has been the most popular member for anticoagulation therapy. Close to 70% of ... so possesses thrombolytic features. Outside of these features, larger dextrans, which do not pass out of the vessels, are ... Brooks and others recommend the avoidance of dextran therapy in patients with chronic kidney disease. Efforts have been made to ...
Temple University School of Medicine
Sol Sherry MD, revolutionized the treatment of acute MI through his pioneering work in thrombolytic therapy and trained many of ... Joseph Wolpe M.D., psychiatrist and father of behavioral modification therapy Bernard T. Mittemeyer M.D., former Surgeon ...
Combined therapies of hypothermia and pharmacological agents or growth factors to improve neurological outcomes are most likely ... but the bleeding risks associated with thrombolytic agents are still unclear. Heparin, an anticoagulant, treatments have been ... but it is not yet known if this therapy is likely to be successful. Aden, U. (2009). Neonatal Stroke Is Not a Harmless ... it is not yet known if this therapy is likely to be successful. Neonatal strokes may lead to cerebral palsy, learning ...
... contains proteins and other substances that are useful for medical therapy and are ingredients in many prescription drugs ... which is used clinically as a thrombolytic agent. Urine contains large quantities of nitrogen (mostly as urea ... Drinking urine (urophagia) Ureotelic Urine therapy Urolagnia, an attraction to urine Cite error: The named reference diet-adj ... health implication of urine therapy Many physicians in ancient history resorted to the inspection and examination of the urine ...
Acute coronary syndrome
The time frame for door-to-needle thrombolytic administration according to American College of Cardiology (ACC) guidelines ... Cardiovascular Diagnosis and Therapy. 9 (3): 281-298. doi:10.21037/cdt.2019.04.03. PMC 6603494. PMID 31275818. Tamis-Holland, ...
The multidisciplinary approach combining angiography, high-resolution ultrasound, thrombolytic therapy, plaque pathology, ...
... and has resulted in improper diagnosis and treatment including unnecessary use of thrombolytic therapy. Numerous diagnoses and ...
In 2012, Whitlock authored the 2012 American College of Chest Physicians guideline on antithrombotic and thrombolytic therapy ...
St. Francis Hospital (Columbus, Georgia)
Breast cancer is typically treated by using a combination of local therapy as well as systemic therapy. The goal of local ... In a typical cardiac emergency, thrombolytic drugs can be utilized sometimes in order to dissolve blood clots and as a useful ... Systemic therapy involves destroying tumor cells that may have diluted into the circulation while at the same time it minimizes ... Francis Orthopaedic Institute, the physical therapy gymnasium of the St. Francis Rehabilitation Center, and the operating rooms ...
... (SK) is a thrombolytic medication and enzyme. As a medication it is used to break down clots in some cases of ... unresponsive to emergency therapy) For streptokinase, prior treatment within the previous 6 months History of chronic, severe, ... internal bleeding Noncompressible vascular punctures Active peptic ulcer Oral anticoagulant therapy Streptokinase belongs to a ...
Choose the best candidates from pre-clinical (animal) studies A 2006 analysis of studies for 1,026 therapies in stroke and ... Clinical trial number NCT02452502 for "The Safety and Efficacy Study of High Dose Atorvastatin After Thrombolytic Treatment in ... Pasban E, Panahpour H, Vahdati A (June 2017). "Early oxygen therapy does not protect the brain from vasogenic edema following ... Nighoghossian N, Ovize M, Mewton N, Ong E, Cho TH (2016). "Cyclosporine A, a Potential Therapy of Ischemic Reperfusion Injury. ...
... anti-platelet therapy like aspirin and clopidogrel, and thrombolytic therapy like alteplase and streptokinase. If an embolus is ... Amin; Kresowik; Nicholson (2014). Current Therapy in Vascular and Endovascular Surgery, Fifth Edition. Elsevier. pp. 629-631. ...
Ischemic Stroke Complicating Thrombolytic Therapy for STEMI
These two cases highlight the rare complication of ischemic stroke following fibrinolytic therapy for STEMI. What mechanism ... Ischemic Stroke Complicating Thrombolytic Therapy With Tenecteplase for ST Elevation Myocardial Infarction. Two Case Reports. ... The two cases on which we report shed light on the association between fibrinolytic therapy and ischemic stroke, the ... With these observations in mind we report two interesting cases of ischemic stroke which occurred after fibrinolytic therapy ...
Thrombolytic therapy and mortality in patients with acute pulmonary embolism
... thrombolytic therapy was used infrequently. Risk of in-hospital and 30-day mortality appears to be elevated for patients who ... were unlikely candidates for this therapy based on characteristics at presentation, but not for pat … ... received thrombolytic therapy. The overall 30-day mortality rate for patients who received thrombolytic therapy was 17.4% ... Thrombolytic therapy and mortality in patients with acute pulmonary embolism Arch Intern Med. 2008 Nov 10;168(20):2183-90. doi ...
Thrombolytic therapy: MedlinePlus Medical Encyclopedia
Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks ... thrombolytic therapy; Heart attack - thrombolytic therapy; Stroke - thrombolysis; Heart attack - thrombolysis; Myocardial ... Reperfusion therapy; Stroke - thrombolytic; Heart attack - thrombolytic; Acute embolism - thrombolytic; Thrombosis - ... Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks ...
Venous Thromboembolism (VTE) Treatment & Management: Approach Considerations, Anticoagulant Therapy, Thrombolytic Therapy
Thrombolytic Therapy. Thrombolytic therapy dissolves recent clots promptly by activating a plasma proenzyme, plasminogen, to ... Thrombolytic therapy speeds pulmonary tissue reperfusion and rapidly reverses right heart failure. It also improves pulmonary ... Anticoagulant and thrombolytic therapy options are available for the treatment of venous thromboembolism (VTE). Anticoagulant ... Heparin therapy should be discontinued immediately before delivery, and then both heparin and warfarin therapy can be started ...
Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction
The National Institutes of Health (NIH) Consensus Development Program: Thrombolytic Therapy in Thrombosis
... following initiation of thrombolytic therapy, reaching a maximum in approximately six hours. *Thrombolytic therapy helps to ... the normal control value before thrombolytic therapy is started. *Begin the thrombolytic infusion. During therapy there should ... What Are the Economic Aspects Involved in Thrombolytic Therapy? The thrombolytic agents available at present, streptokinase and ... therapy for these disorders. With the advent of thrombolytic therapy, this is no longer true for a large number of cases. ...
Thrombolytic therapy in A&E departments in the U.K. | Emergency Medicine Journal
Thrombolytic therapy - SmartEngage
... thrombolytic therapy; Heart attack - thrombolytic therapy; Stroke - thrombolysis; Heart attack - thrombolysis; Myocardial ... Reperfusion therapy; Stroke - thrombolytic; Heart attack - thrombolytic; Acute embolism - thrombolytic; Thrombosis - ... Thrombolytic therapy. Tissue plasminogen activator; TPA; Alteplase; Reteplase; Tenecteplase; Activase thrombolytic agent; Clot- ... Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks ...
Guidelines for Thrombolytic Therapy for Frostbite - PubMed
The data are insufficient to support standardized treatment of all patients with frostbite with thrombolytic therapy. The ... Use of Intra-arterial Thrombolytic Therapy for Acute Treatment of Frostbite in 62 Patients with Review of Thrombolytic Therapy ... Guidelines for Thrombolytic Therapy for Frostbite Sean Hickey 1 , Amy Whitson 2 , Larry Jones 2 , Lucy Wibbenmeyer 3 , Colleen ... Guidelines for Thrombolytic Therapy for Frostbite Sean Hickey et al. J Burn Care Res. 2020. . ...
The National Institutes of Health (NIH) Consensus Development Program: Thrombolytic Therapy in Thrombosis
... following initiation of thrombolytic therapy, reaching a maximum in approximately six hours. *Thrombolytic therapy helps to ... the normal control value before thrombolytic therapy is started. *Begin the thrombolytic infusion. During therapy there should ... What Are the Economic Aspects Involved in Thrombolytic Therapy? The thrombolytic agents available at present, streptokinase and ... therapy for these disorders. With the advent of thrombolytic therapy, this is no longer true for a large number of cases. ...
Frequency of thrombolytic therapy in patients with acute ischemic stroke and the risk of in-hospital mortality: the german...
Frequency of thrombolytic therapy in patients with acute ischemic stroke and the risk of in-hospital mortality: the german ... Frequency of thrombolytic therapy in patients with acute ischemic stroke and the risk of in-hospital mortality: the german ... Frequency of thrombolytic therapy in patients with acute ischemic stroke and the risk of in-hospital mortality: the german ...
Predictors of in-hospital and long-term clinical outcome in elderly patients with massive pulmonary embolism receiving...
... receiving thrombolytic therapy for pulmonary embolism (PE). DESIGN: Case-control retrospective study. SETTING: General medicine ... receiving thrombolytic therapy for pulmonary embolism (PE). DESIGN: Case-control retrospective study. SETTING: General medicine ... receiving thrombolytic therapy for pulmonary embolism (PE). DESIGN: Case-control retrospective study. SETTING: General medicine ... receiving thrombolytic therapy for pulmonary embolism (PE). DESIGN: Case-control retrospective study. SETTING: General medicine ...
Myocardial Infarction Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care
Thrombolytic Therapy. Thrombolytic therapy has been shown to improve survival rates in ST-segment elevation myocardial ... Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and ... Anticoagulation and Thrombolytic Therapy in STEMI. In the previous 2004 guidelines on STEMI management, patients treated with ... 61] Thrombolytic therapy administered within the first 2 hours can occasionally abort myocardial infarction and dramatically ...
Sudden Unilateral Vision Loss in a Patient Who Received Intravenous Thrombolytic Therapy<...
Sudden Unilateral Vision Loss in a Patient Who Received Intravenous Thrombolytic Therapy. Chest. 2021 Dec;160(6):e669-e672. ... Sudden Unilateral Vision Loss in a Patient Who Received Intravenous Thrombolytic Therapy. / Shah, Tejas E.; Vij, Rohin; Kim, Yu ... title = "Sudden Unilateral Vision Loss in a Patient Who Received Intravenous Thrombolytic Therapy", ... Sudden Unilateral Vision Loss in a Patient Who Received Intravenous Thrombolytic Therapy. ...
Should older patients with acute myocardial-infarction receive thrombolytic therapy
Subjects: Thrombolytic Therapy - Digital Collections - National Library of Medicine Search Results
Start Over You searched for: Subjects Thrombolytic Therapy ✖Remove constraint Subjects: Thrombolytic Therapy ... Thrombolytic Therapy. Thrombosis -- drug therapy. Thrombosis -- prevention & control. Venous Thromboembolism -- drug therapy. ... Cerebrovascular Disorders -- drug therapy. Embolism -- drug therapy. Fibrinolytic Agents -- therapeutic use. Medication Therapy ... Thrombolytic Therapy. Venous Thrombosis -- prevention & control. Humans. Indiana. United States 2. Antithrombotics: indications ...
Thrombolytic Therapy: Background, Thrombolytic Agents, Thrombolytic Therapy for Acute Myocardial Infarction
What are the thrombolytic therapy options for pulmonary embolism (PE)?. What is the efficacy of thrombolytic therapy for ... Why is thrombolytic therapy indicated in patients with coronary atherosclerosis?. What is the mainstay of thrombolytic therapy ... Complications of Thrombolytic Therapy. Prior to thrombolytic therapy, risk assessment is mandatory. Particular safety concerns ... What are limitations of thrombolytic therapy for deep vein thrombosis (DVT)?. What is the role of systemic thrombolytic therapy ...
Repeated Thrombolytic Therapy in Patients with Recurrent Acute Ischemic Stroke
Thrombolytic therapy. The detailed protocol for thrombolytic treatment has been previously reported.16-19 Thrombolytic ... Repeated thrombolytic therapy could be considered, even if patients have had previous history of thrombolytic treatments. ... We explored the number and outcome of patients with repeated thrombolytic therapy in the era of multimodal thrombolytic ... The median time from the onset of symptoms to thrombolytic therapy was 120 hours for the first thrombolytic treatment, and 125 ...
Acute Management of Stroke: Initial Treatment, Thrombolytic Therapy, Stabilization of Airway and Breathing
Thrombolytic Therapy. Current treatments for acute ischemic stroke include IV thrombolytic therapy with tissue-type plasminogen ... most likely to benefit from thrombolytic therapy and the potential benefits of extending the window for thrombolytic therapy ... The iScore predicts effectiveness of thrombolytic therapy for acute ischemic stroke. Stroke. 2012 May. 43(5):1315-22. [QxMD ... What is the indication for thrombolytic therapy in the acute management of stroke? ...
Preventing Chronic Disease | Emergency Medical Services Capacity for Prehospital Stroke Care in North Carolina - CDC
Not included in basic topics was thrombolytic therapy. One system did not answer the question on thrombolytic therapy, and one ... Not included was thrombolytic therapy.. f Determined by Fisher exact test.. g Validated stroke scales and screens named on the ... notably thrombolytic therapy (1). With proper education and use of protocols, EMS personnel can screen for stroke in the field ... education on thrombolytic therapy, and a policy to notify hospitals in advance. Although we observed positive changes overall, ...
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. part 33 « Diabetes: symptoms, causes, prevention, care...
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. part 33. Thus, ximelagatran therapy is a promising ... Home , Other , The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. part 33 ... We do not yet know whether therapy with aspirin plus clopidogrel is as effective as warfarin therapy, or whether treatment with ... However, recent results with warfarin raise the possibility that ximelagatran therapy may be useful for this indication, either ...
Special Issues - Thrombosis Research - Journal - Elsevier
Thrombolytic drug therapy involves the use of fibrinolytic agents that break up fibrin, a core component of clots. These ... Thrombolytic Therapy. Some patients who have massive blood clots, or disease that progresses despite anticoagulant treatment, ... that do not involve the use of thrombolytic or clot-dissolving therapies. ... More recently, with some high-risk cases of pulmonary embolism, advanced therapies like mechanical thrombectomy may be used in ...
HTA 101: X. Selected Issues in HTA
Thrombolytic therapy for ischemic stroke. Box X-2 shows examples of health technologies for which good evidence exists of ... and gene therapy substituting for some pharmaceutical or biological therapies (Wilson 2012). Disruptive innovations can present ... Also, therapies that do not yield a statistically significant treatment effect across a study population―and that may be ... Therapies that yield a statistically significant treatment effect across a study population may not necessarily work for all ...
human cardiovascular system (anatomy) | Britannica
Dr. Michael Ginsburg, MD | Pleasant Prairie, WI | Healthgrades
Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism - Université de Bretagne...
Impact of Hospital Level on Stroke Outcomes in the Thrombolytic Therapy Era in Northeast Thailand: A Retrospective Study
Refludan®50 mg/vial lepirudin (rDNA) for injection
Monitoring and Adjusting Therapy; Concomitant Use With Thrombolytic Therapy.) ... Concomitant Use With Thrombolytic Therapy. Clinical trials in HIT patients have provided only limited information on the ... It occurred in patients with acute myocardial infarction who were started on both REFLUDAN and thrombolytic therapy with rt-PA ... There have been reports of intracranial bleeding with REFLUDAN in the absence of concomitant thrombolytic therapy (see ADVERSE ...
IschemicThrombosisStreptokinaseTimes for thrombolytic therapyAngioplastyStrokeAlteplaseAnticoagulationSubmassive pulmonaryEfficacyTherapeuticThrombolysisMyocardial infarctionMortalityAntithromboticBypass graftsPatencyRisk of recurrentAdjunctiveInfusionAnticoagulantHeparinMedicationsOutcomeACCPPatientsProstheticDissolveTissueAgentsVersusBloodWoundVascularAgentMedicinesEchocardiographyReducesHealthcareSystemicGuidelinesSymptomsOutcomesJournalDrugsDrug
- After numerous case series and smaller prospective studies suggesting benefit for thrombolytic therapy (tPA), the early 90s ushered in the era of thrombolytic RCTs for acute ischemic stroke. (emottawablog.com)
- The date associated with the time that Intra-arterial (IA) thrombolytic therapy was initiated to a patient with ischemic stroke at this hospital. (jointcommission.org)
- Efficacy of telemedicine for thrombolytic therapy in acute ischemic stroke: A meta-analysis. (mayoclinic.org)
- BACKGROUND: The benefit of intravenous thrombolytic therapy for acute ischemic stroke is time dependent. (duke.edu)
- METHODS: We analyzed Medicare beneficiaries aged ≥65 years receiving intravenous thrombolytic treatment for acute ischemic stroke at 1490 Get With The Guidelines-Stroke hospitals during January 2006 and December 2009 (preintervention, n=10 804) and January 2010 and December 2014 (postintervention, n=31 249). (duke.edu)
- CONCLUSIONS: Target: stroke quality initiative was associated with faster thrombolytic treatment times for acute ischemic stroke and modestly lower 1-year all-cause and cardiovascular readmissions. (duke.edu)
- Adjunctive anti-ischemic therapies such as intravenous nitroglycerin or beta blockade can be useful to minimize ischemia. (blogspot.com)
- Thrombolytic therapy has been described in several case reports as beneficial in patients with cerebral venous thrombosis (CVT). (medscape.com)
- Anticoagulation and thrombolytic therapy were also given for treatment of a left popliteal artery thrombosis. (hindawi.com)
- Purpose: To develop a porcine carotid artery thrombosis model for the evaluation of thrombolytic therapy and adjunctive angioplasty procedures. (houstonmethodist.org)
- Deep vein thrombosis (DVT) can be treated with medical therapy and/or surgical intervention. (nm.org)
- Thrombolytic Therapy for Prosthetic Valve Thrombosis in Pregnant Women? (jwatch.org)
- Blood thinning agents is usually the first choice of therapy for acute Deep Vein Thrombosis. (myzeo.com)
- CONCLUSION: Prosthetic valve thrombosis was accompanied by sub-optimal anticoagulant therapy. (bvsalud.org)
- Streptokinase infusion initially yielded conflicting results until the Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico (GISSI) trial in 1986, which validated streptokinase as an effective therapy and established a fixed protocol for its use in AMI. (medscape.com)
- Streptokinase therapy followed by intravenous heparin infusion was given and the clot lysed successfully. (who.int)
Times for thrombolytic therapy1
- To assist hospitals in providing faster thrombolytic treatment, the American Heart Association launched target: stroke quality initiative in January 2010 which disseminated feasible strategies to shorten door-to-needle times for thrombolytic therapy. (duke.edu)
- Further therapy, such as cardiac catheterization with angioplasty and stenting, may be needed. (medlineplus.gov)
- thrombolytic agents, angioplasty and valves. (who.int)
- A large randomised multicentre trial is needed to compare the relative merits of intravenous thrombolytic treatment in a local hospital with primary angioplasty after transfer in selected high risk patients with acute myocardial infarction. (bmj.com)
- Several randomised trials have recently shown that primary coronary angioplasty-defined as angioplasty performed on the infarct related vessel-during the early hours of acute myocardial infarction, without the use of thrombolytic agents, offers certain advantages over intravenous thrombolytic treatment. (bmj.com)
- The time loss and the risks associated with transportation might negate (part of) the benefits of primary angioplasty compared to thrombolytic treatment. (bmj.com)
- To compare intravenous thrombolytic treatment in a local facility with primary coronary angioplasty after transportation to a referral centre for interventional treatment of coronary artery disease, a multicentre randomised trial is currently planned in The Netherlands. (bmj.com)
- Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke. (medlineplus.gov)
- Thrombolytic medicines are approved for the emergency treatment of stroke and heart attack . (medlineplus.gov)
- Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). (nih.gov)
- Thrombolytic Therapy: A Stroke of Luck? (emottawablog.com)
- Also in 2001, the ICRH/Heart and Stroke Foundation sponsored the Canadian Consensus Conference on Acute Stroke Imaging of Thrombolytic Therapy. (nih.gov)
- Recent recommendations from the American Heart Association/American Stroke Association and FDA remove or make less specific many previous contraindications and warnings for therapy. (jointcommission.org)
- Our analyses of immune cell subsets suggest that BR therapy substantially decreases neutrophils in blood following a stroke. (nature.com)
- Electrochemiluminescence detection demonstrates that BR therapy reduces cytokine storm in plasma and ELISA demonstrates reduced levels of matrix metalloproteinase-9 (MMP-9) in the plasma and brains at different time points post-stroke. (nature.com)
- Our study is the first to show that BR therapy leads to profoundly improved stroke outcomes in mice and that the improved outcomes are mediated via MMP-9. (nature.com)
- Current treatments for acute stroke include thrombolytic therapy through the administration of tissue plasminogen activator and the surgical removal of the clot. (nature.com)
- These results reveal a possible therapy of using blood for brain protection from a stroke. (nature.com)
- His special interests include thrombolytic therapy, mechanical thrombectomy, stroke, long term management of stroke/rehabilitation, subarachnoid and intracerebral hemorrhage. (neurox.us)
- Regarding catheter-directed therapy, patients who received low-dose catheter-directed alteplase were also concurrently anticoagulated with systemic unfractionated heparin in the Ultrasound-Assisted, Catheter-Directed Th rombolysis for Acute Intermediate-Risk Pulmonary Embolism (ULTIMA) trial. (ccjm.org)
- [ 27 ] Guidelines have been developed for optimal management of anticoagulation therapy in patients with VTE. (medscape.com)
- In a study of patients with a first VTE who did not have cancer and who received different durations of anticoagulant treatment, the results indicated a similar risk of recurrent VTE whether anticoagulation therapy was stopped after 3 months or a longer period of treatment was provided. (medscape.com)
- Specific therapy for CVT involves anticoagulation or thrombolytic therapy. (medscape.com)
- Existing data support the use of systemic anticoagulation as an initial therapy in all patients, even in the presence of intracranial hemorrhage. (medscape.com)
- The efficacy of thrombolytic therapy was assessed using carotid arteriography and intravascular ultrasound. (houstonmethodist.org)
- Artificial intelligence-assisted selection and efficacy prediction of antineoplastic strategies for precision cancer therapy. (cdc.gov)
- Further, addition of MMP-9 in blood diminishes therapeutic effects of the BR therapy. (nature.com)
- Fibrin-bound plasminogen will be converted by thrombolytic drugs to plasmin, the rate-limiting step in thrombolysis. (medscape.com)
- The findings of this overview demonstrate that insufficient clinical outcome data are available to support or to refute the routine use of intravenous heparin therapy after thrombolysis. (ox.ac.uk)
- Overview of randomized trials of intravenous heparin in patients with acute myocardial infarction treated with thrombolytic therapy. (ox.ac.uk)
- Intravenous heparin is routinely given after thrombolytic therapy for patients with acute myocardial infarction in the United States and in some, but by no means all, other countries. (ox.ac.uk)
- 1-4 Rapid and sustained patency of the infarct related vessel is obtained in most patients, resulting in a lower mortality and less reinfarction without exposing them to the bleeding risks associated with thrombolytic treatment. (bmj.com)
- Large randomized studies of heparin (and of new antithrombotic regimens) are needed to establish the role of such therapy. (ox.ac.uk)
- Since publication of the seventh American College of Chest Physicians (ACCP) supplement on antithrombotic and thrombolytic therapy, the results of clinical trials have provided important new information on the management of thromboembolic disorders, and the science of developing recommendations has advan. (bvsalud.org)
- Thrombolytic therapy for thrombosed arterial bypass grafts has received little attention in the medical literature. (jamanetwork.com)
- Follow-up showed continued patency nine months following thrombolytic therapy. (jamanetwork.com)
Risk of recurrent1
- The researchers discovered that thrombolytic therapy lowered the risk of recurrent pulmonary embolism by 60 percent compared to anticoagulant therapy. (rxwiki.com)
- It provides not only a model for the evaluation of thrombolytic therapy but also a practical training tool for adjunctive endovascular interventions. (houstonmethodist.org)
- These preliminary results suggest that transjugular local infusion of thrombolytic agents can be an effective treatment for symptomatic, thrombosed dural sinuses. (elsevier.com)
- These patients were treated with infusion of a thrombolytic agent into the dural venous sinus, utilizing microcatheter technique. (medscape.com)
- Anticoagulant and thrombolytic therapy options are available for the treatment of venous thromboembolism (VTE). (medscape.com)
- Anticoagulant therapy prevents further clot deposition and allows the patient's natural fibrinolytic mechanisms to lyse the existing clot. (medscape.com)
- A recent review of studies found that thrombolytic therapy (dissolving of blood clots) for pulmonary embolism lowered the risk of death compared to anticoagulant therapy (prevention of blood clots). (rxwiki.com)
- The researchers also found that thrombolytic therapy carried an increased risk for major bleeding in comparison to anticoagulant therapy. (rxwiki.com)
- The review included 16 studies published between 1970 and 2014 that compared thrombolytic therapy to anticoagulant therapy for pulmonary embolism patients. (rxwiki.com)
- Thrombolytic therapy involves using medication to breakup blood clots, whereas anticoagulant therapy involves using medication to reduce the body's ability to make clots in the first place. (rxwiki.com)
- The findings showed that thrombolytic therapy reduced the risk of death by 47 percent compared to anticoagulant therapy. (rxwiki.com)
- The patients who had thrombolytic therapy were 2.73 times more likely to have major bleeding, and 4.63 times more likely to have an intracranial hemorrhage, than those who received anticoagulant therapy. (rxwiki.com)
- The pulmonary embolism patients who were 65 years old and younger only had a 25 percent increased risk of major bleeding with thrombolytic therapy versus anticoagulant therapy. (rxwiki.com)
- When analysis was restricted to the eight studies that included intermediate-risk pulmonary embolism patients, thrombolytic therapy lowered the risk of death by 52 percent and increased the risk of major bleeding events by 3.19 times compared to anticoagulant therapy. (rxwiki.com)
- More research is also needed to see if anticoagulant medication could be used in combination with thrombolytic therapy. (rxwiki.com)
- Two patients responded to heparinization and optimization of anticoagulant therapy. (bvsalud.org)
- According to the guidelines , in patients with VTE (DVT of the leg or PE), direct-acting oral anticoagulants (DOACs), specifically apixaban, dabigatran, edoxaban, or rivaroxaban, are recommended over vitamin K antagonists (VKAs) as treatment-phase (first 3 months) anticoagulant therapy. (medscape.com)
- Heparin therapy should be discontinued immediately before delivery, and then both heparin and warfarin therapy can be started post partum. (medscape.com)
- Heparin is the first line of therapy. (medscape.com)
- We performed a systematic overview of the 6 randomized controlled trials (1,735 patients) to summarize the available data concerning the risks and benefits of intravenous heparin versus no heparin after thrombolytic therapy. (ox.ac.uk)
- Similar rates of recurrent ischemia and reinfarction were observed among those allocated to heparin therapy or control. (ox.ac.uk)
- Also, the studies used various types and doses of thrombolytic medications, and the researchers did not have data on patient characteristics such as demographics or medical history. (rxwiki.com)
- however, as the NINDS investigators concluded, the earlier that IV thrombolytic therapy is initiated, the better the patient outcome. (jointcommission.org)
- Regardless, Dr. Katyal is correct in highlighting that the new 2016 ACCP guidelines now give a grade of 2B for thrombolytic therapy in the treatment of massive pulmonary embolism. (ccjm.org)
- At our institution, the current practice is to target an anti-Xa level of 0.3 to 0.7 μg/mL in patients receiving catheter-directed therapy for large-volume pulmonary embolism. (ccjm.org)
- Les dossiers de 622 patients âgés en moyenne de 58,3 ans (écart type 12,9) ont été étudiés. (who.int)
- Des stratégies préventives doivent être mises en œuvre afin d'améliorer le pronostic à long terme des patients libyens et de réduire la morbidité et la mortalité globales dues à la coronaropathie. (who.int)
- Identify appropriate pulmonary embolism patients for catheter-based therapy. (chestnet.org)
- Describe need for thrombolytic therapy in patients with intermediate risk PE. (chestnet.org)
- Eleven patients received thrombolytic therapy and nine of them responded to it. (bvsalud.org)
- Most patients responded to medical therapy alone. (bvsalud.org)
- In most patients with acute PE that is not associated with hypotension, the guidelines recommend against systemically administered thrombolytic therapy. (medscape.com)
- The history of thrombolytic therapy began in 1933, when it was discovered that filtrates of broth cultures of certain streptococcal strains (beta-hemolytic streptococci) could dissolve a fibrin clot. (medscape.com)
- Thrombolytic therapy is a treatment in which you are given medicines through a drip to dissolve a blood clot that is narrowing or blocking a coronary artery. (wa.gov.au)
- In certain situations, a thrombolytic medication may be used to dissolve the blood clot. (nm.org)
- The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same thing. (medlineplus.gov)
- The thrombolytic agents available today are serine proteases that work by converting plasminogen to the natural fibrinolytic agent plasmin. (medscape.com)
- Versus, electrophysiologic study indicated that initial thrombolytic therapy in acute ingestions. (aaan.org)
- The development of novel cell tracking methodologies for cell localization represent part of the Strategic Plan for Cell-based Therapies for Heart, Lung, Blood and Sleep Disorders developed by the Working Group on Cell-based Therapies in May 2002. (nih.gov)
- Further, we have demonstrated that the addition of MMP-9 to the blood diminishes the protective effect of the BR therapy. (nature.com)
- The traditional treatment of subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm included strict blood pressure control, with fluid restriction and antihypertensive therapy. (medscape.com)
- Thrombolytic therapy */ @213 WOUND 1. (cdc.gov)
- Thrombolytic therapy should play an increasing role in vascular surgery. (jamanetwork.com)
- t-PA has increasingly been used as the first-choice thrombolytic agent. (medscape.com)
- Ideally, you should receive thrombolytic medicines within the first 30 minutes after arriving at the hospital for treatment. (medlineplus.gov)
- Echocardiography provides rapid, noninvasive assessment of cardiac structure and function, detects intracardiac thrombi when present, and assists in formulating appropriate therapy and prognosis. (vin.com)
- Following the treatment, we demonstrate that the BR therapy significantly reduces the cytokine storm in the plasma. (nature.com)
- Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. (wa.gov.au)
- This selective lysis avoids thrombolytic effects that could aggravate or produce systemic hemorrhagic complications. (elsevier.com)
- Results Current guidelines and reviews propose different criteria and recommendations for SVT treatment, whereupon an increasing stringency in the therapy recommendations in recent years can be observed. (thieme-connect.de)
- The Ozonated Oils are amazing skin care products widely used for effective therapy of acne, eczema and psoriasis symptoms, wounds, burns of different origin, as well as some other skin imperfections such as cellulite and wrinkles. (ozonefactory.net)
- Outcomes are better if you receive a thrombolytic drug within 12 hours after the heart attack starts. (medlineplus.gov)
- Improving Outcomes in Liver Transplantation From Donation After Circulatory Death: The Role of Thrombolytic Therapy. (ochsner.org)
- Journal of Endovascular Therapy , 7 (3), 227-235. (houstonmethodist.org)
- What are thrombolytic drugs? (clevelandclinic.org)
- Many providers outside the United States choose this because it's cheaper than other thrombolytic drugs. (clevelandclinic.org)
- Accordingly, it is necessary to use measures for rational use of drug therapy 1 . (bvsalud.org)