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 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.
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.
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
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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
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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 ...
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"Thrombolytic therapy: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-19.. ... Thrombolytic therapy: is a treatment used to break up masses of plaque inside the arteries via intravenous clot-dissolving ... Medical therapy for underlying conditions, such as medications for the treatment of high cholesterol, medications to treat high ...
Proteases (medical and related uses)
"Thrombolytic Therapy". Medscape. Wardlaw JM, Murray V, Berge E, del Zoppo G, Sandercock P, Lindley RL, Cohen G (June 2012). " ... 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, ...
Vanderschueren S, Van de Werf F, Collen D (August 1997). "Recombinant staphylokinase for thrombolytic therapy". Fibrinolysis ...
Nakamura S, Takano H, Kubota Y, Asai K, Shimizu W (July 2014). "Impact of the efficacy of thrombolytic therapy on the mortality ... Cochrane Vascular Group) (December 2018). "Thrombolytic therapy for pulmonary embolism". The Cochrane Database of Systematic ... Anticoagulation therapy is usually continued for 3-6 months, or "lifelong" if there have been previous DVTs or PEs, or none of ... Anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia, may be ...
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 ...
... therapy uses thrombolytic drugs that dissolve blood clots. Most of these drugs target fibrin (one of the main ... In people who receive thrombolytic therapy delivered through a catheter, there is a risk of hemorrhage as a side effect. ... Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an ... Angiograph before and after thrombolytic therapy in a case of acute limb ischemia. ...
Baskin JL, Reiss U, Wilimas JA, Metzger ML, Ribeiro RC, Pui CH, Howard SC (May 2012). "Thrombolytic therapy for central venous ... Sharobeam A, Jones B, Walton-Sonda D, Lueck CJ (March 2020). "Factors delaying intravenous thrombolytic therapy in acute ... Ucar EY (June 2019). "Update on Thrombolytic Therapy in Acute Pulmonary Thromboembolism". The Eurasian Journal of Medicine. 51 ... Similar to other thrombolytic drugs, alteplase is used to dissolve clots to restore tissue perfusion, but this can vary ...
Recent administration (within 3 days) of thrombolytic therapy. *Recent administration (within 7 days) of oral anticoagulants or ... The following patients are at an increased risk for bleeding complications due to drotrecogin-alpha therapy, and a careful risk ...
Clot busting agents or thrombolytic therapy are a treatment option for migrainous infarction caused by enhanced platelet ... Hommel, M. (1996-07-18). "Thrombolytic Therapy with Streptokinase in Acute Ischemic Stroke". New England Journal of Medicine. ... "Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke ( ... Streptokinase is a thrombolytic agent which aims to permit reperfusion, allowing the restoration of blood flow to the ischaemic ...
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. ...
... percutaneous mechanical thrombectomy and thrombolytic therapies". American Journal of Therapeutics. 21 (2): 131-6. doi:10.1097/ ...
... 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. ...
Pre-hospital thrombolytic therapy in patients with suspected acute myocardial infarction. NEJM 1993:329:383-9 Moleur P, ...
深靜脈血栓 - 維基百科，自由的百科全
Antithrombotic and Thrombolytic Therapy, 8th Ed: ACCP Guidelines. Chest (American College of Chest Physicians). June 2008, 133 ...
Potato carboxypeptidase inhibitor, a natural peptide usable for thrombolytic and cancer therapy ...
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. ... the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest. 126 (3 Suppl): 338S-400S. doi:10.1378/chest. ... Ovarian hyper-stimulation therapy to treat infertility.  Compression of a vein or artery by abnormality, tumor, hematoma. [8 ... Treatment varies between therapy and surgical intervention by the use of shunts. ...
Thrombolytic therapy is used in myocardial infarction, cerebral infarction, and, on occasion, in massive pulmonary embolism. ... Treatment of established arterial thrombosis includes the use of antiplatelet drugs and thrombolytic therapy. Antiplatelet ... Antiplatelet therapy with one or more of these drugs decreases the ability of blood clots to form by interfering with the ... This is known as "dual antiplatelet therapy" (or DAPT). The class of antiplatelet drugs include: Irreversible cyclooxygenase ...
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 ... Eikelboom JW, Weitz JI (2010). "Update on Antithrombotic Therapy: New Anticoagulants". Circulation. 121: 1523-32. doi:10.1161/ ...
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest. 126 (3): 188S-203S. doi:10.1378/chest.126.3_ ... 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 (20 May 2005). "A novel purification strategy for tetrovirus gene therapy vectors using ...
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 ...
Հեպարին - Վիքիպեդիա՝ ազատ հանրագիտարան
The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy»։ Chest 126 (3): 188S-203S։ PMID 15383472։ doi:10.1378/ ... Principles of Antithrombotic Therapy»։ Williams Hematology (7th ed.)։ 2006։ ISBN 978-0-07-143591-8։ Արխիվացված է օրիգինալից ... A novel purification strategy for tetrovirus gene therapy vectors using heparin affinity chromatography»։ Biotechnol Bioeng 4 ( ...
Strok bahasa Indonesia, ensiklopedia bebas
"Reducing bleeding complications after thrombolytic therapy for stroke: clinical potential of metalloproteinase inhibitors and ... "Microplasmin: a novel thrombolytic that improves behavioral outcome after embolic strokes in rabbits". Department of ... Hyperbaric oxygen therapy telah dipelajari sebagai kemungkinan perlindungan, tetapi akhir-akhir ini dipikirkan bahwa terapi ini ... "Tumor necrosis factor-alpha is involved in thrombolytic-induced hemorrhage following embolic strokes in rabbits". Department of ...
உயிர்ச்சத்து கே - தமிழ் விக்கிப்பீடியா
... the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest 126 (3 Suppl): 204S-233S. doi:10.1378/chest. ...
Anticoagulants and thrombolytic medications also increase the likelihood of bleeding. Medications used to treat cancer can ... with oral therapy used as a continuation after the initial IM or IV dose. ... interact with ketorolac along with radiation therapy. The risk of toxicity to the kidneys increases when ketorolac is taken ... "Patient considerations in cataract surgery - the role of combined therapy using phenylephrine and ketorolac". Patient ...
குழலியக்குருதியுறைமை - தமிழ் விக்கிப்பீடியா
... the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest 126 (3 Suppl): 338S-400S. doi:10.1378/chest. ...
"Antithrombotic Therapy in Atrial Fibrillation : The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy". Chest ... Antiarrhythmic drug therapy is indicated as first-line therapy for AF that remains symptomatic despite adequate rate control.. ... Pariaut, R (September 2017). "Atrial Fibrillation: Current Therapies". The Veterinary Clinics of North America. Small Animal ... There is tentative evidence that left atrial appendage occlusion therapy may reduce the risk of stroke in people with non- ...
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 ...
Թրոմբոզ - Վիքիպեդիա՝ ազատ հանրագիտարան
... the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy»։ Chest 126 (3 Suppl): 338S-400S։ PMID 15383478։ doi: ...
... an example of proapoptotic signal modulation therapy". Integrative Cancer Therapies. 5 (3): 252-68. doi:10.1177/ ... "Expert Review of Anti-Infective Therapy. 8 (2): 197-203. doi:10.1586/eri.09.109. PMC 2845298. PMID 20109049.. ... The therapy often lasts for one to two weeks, and is rarely indicated for longer periods. After fever and pain have subsided, ... Aspirin, especially as a component of an aspirin/paracetamol/caffeine combination, is considered a first-line therapy in the ...
Some indications for anticoagulant therapy that are known to have benefit from therapy include: *Atrial fibrillation - commonly ... Anticoagulants are closely related to antiplatelet drugs and thrombolytic drugs by manipulating the various pathways of blood ... February 2016). "Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report". Chest. 149 (2): 315-352. doi ... American Physical Therapy Association (15 September 2014), "Five Things Physicians and Patients Should Question", Choosing ...
Shortness of breath
Frownfelter, Donna; Dean, Elizabeth (2006). "8". In Willy E. Hammon III (ed.). Cardiovascular and Pulmonary Physical Therapy. 4 ... may warrant the use of thrombolytic drugs. ... Individuals can benefit from a variety of physical therapy ... Frownfelter, Donna; Dean, Elizabeth (2006). "8". In Willy E. Hammon III (ed.). Cardiovascular and Pulmonary Physical Therapy. 4 ... Frownfelter, Donna; Dean, Elizabeth (2006). "32". Cardiovascular and Pulmonary Physical Therapy. 4. Mosby Elsevier. pp. 569-581 ...
阿司匹林 - 維基百科，自由的百科全書
溶血栓藥（英語：Thrombolytic drug）類/. 溶纖維蛋白藥（英語：fibrinolytic）. 纖維蛋白溶酶原激活物類：重組組織纖維溶酶原激活物（英語：Recombinant tissue plasminogen activators）（阿 ... Expert review of anti-infective therapy. February 2010, 8 (2): 197-203. PMC 2845298. PMID 20109049. doi:10.1586/eri.09.109.. ... 抗血栓藥（英語：Antithrombotic）（溶血栓藥（英語：Thrombolytic drug）、抗凝劑與抗血小板藥（英語：antiplatelet drug））（B01） ... Musumeci, G;
Vitamin K antagonist
... therapy remains somewhat circumstantial. The INRs were not collected as carefully during the post-trial period... [and] the ... and end-of-study transition to open-label therapy. / In atrial fibrillation patients who temporarily or permanently ... Thrombolytic drugs/. fibrinolytics. *Plasminogen activators: r-tPA *Alteplase#. *Reteplase. *Tenecteplase. *Desmoteplase†. *UPA ... authors do not provide any information on the use of bridging therapies... with unfractionated or low-molecular-weight heparin ...
WHO Model List of Essential Medicines
as adjunctive therapy for treatment-resistant partial or generalized seizures. *^ For use in eclampsia and severe pre‐eclampsia ... Thrombolytic medicines. *Alteplaseα. *Streptokinaseα. Lipid-lowering agents. *Simvastatin[note 72] ...
Streptokinase, an enzyme produced by streptococcal bacteria, is one of the oldest thrombolytic drugs. This drug can be ... Main articles: Thrombolysis, Thrombosis prophylaxis, and Reperfusion therapy. Anticoagulants are drugs used to prevent the ... Bleeding time with heparin and warfarin therapy can be measured with the partial thromboplastin time (PTT) and prothrombin time ... "Anticoagulation Drug Therapy: A Review". The Western Journal of Emergency Medicine. 16 (1): 11-17. doi:10.5811/westjem.2014.12 ...
Myocardial infarction - Simple English Wikipedia, the free encyclopedia
2.0 2.1 2.2 Thrombolytic Therapy. Chen, M.D., Michael, U.S. National Library of Medicine - National Institutes of Health. ...
ಪಲ್ಮನರಿ ಎಂಬಾಲಿಸಮ್ (ಶ್ವಾಸಕೋಶದ ಧಮನಿಬಂಧ) - ವಿಕಿಪೀಡಿಯ
Dong B, Jirong Y, Liu G, Wang Q, Wu T (2006). "Thrombolytic therapy for pulmonary embolism". Cochrane Database Syst Rev (2): ... 2006). "D-dimer testing to determine the duration of anticoagulation therapy". N. Engl. J. Med. 355 (17): 1780-9. doi:10.1056/ ... 2007). "Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy". Chest. 132 (1 ... White RH (2008). "Risk of fatal pulmonary embolism was 0.49 per 100 person-years after discontinuing anticoagulant therapy for ...
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Heparin and Low-Molecular-Weight Heparin: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. ... 溶血栓药（英语：Thrombolytic drug）类/. 溶纤维蛋白药（英语：fibrinolytic）. 纤维蛋白溶酶原激活物类：重组组织纤维溶酶原激活物（英语：Recombinant tissue plasminogen activators）（阿 ... 抗血栓药（英语：Antithrombotic）（溶血栓药（英语：Thrombolytic drug）、抗凝剂与抗血小板药（英语：antiplatelet drug））（B01） ... Principles of
Some indications for anticoagulant therapy that are known to have benefit from therapy include: *Atrial fibrillation - commonly ... Anticoagulants are closely related to antiplatelet drugs and thrombolytic drugs by manipulating the various pathways of blood ... American Physical Therapy Association (15 September 2014), "Five Things Physicians and Patients Should Question", Choosing ... As a class of medications, anticoagulants are used in therapy for thrombotic disorders. Oral anticoagulants (OACs) are taken by ...
Gene therapy. Viral gene therapy involves artificially manipulating a virus to include a desirable piece of genetic ... Thrombolytic agents (tissue plasminogen activator). *Hormones (insulin, glucagon, growth hormone, gonadotrophins). * ... European Medicines Agency, "tooltip definition of advanced therapy medicinal products", Committee for Advanced Therapies (CAT) ... gene therapies, tissues, recombinant therapeutic protein, and living cells used in cell therapy. Biologics can be composed of ...
... and has resulted in improper diagnosis and treatment including unnecessary use of thrombolytic therapy. ...
Thrombolytic drugs/. fibrinolytics. *Plasminogen activators: r-tPA *Alteplase. *Reteplase. *Tenecteplase. *Desmoteplase†. *UPA ...
These therapies are not routinely recommended. Such complications are suggested to be the main reason for mortality in ... Patients on TPN who have such clots occluding their catheter may receive a thrombolytic flush to dissolve the clots and prevent ... Hyperglycemia is common at the start of therapy, but can be treated with insulin added to the TPN solution. Hypoglycaemia is ...
... there is a window of three hours within which the benefit of thrombolytic drugs outweighs the risk of major bleeding. In the ... Intravenous therapy (IV). *Tracheal intubation. *Laryngeal tube. *Combitube. *Nasopharyngeal airway (NPA). *Oropharyngeal ...
Gustavo S. Oderich (2014). Mesenteric Vascular Disease: Current Therapy. Springer. p. 105. ISBN 9781493918478. Archived from ... but thrombolytic medical treatment and vascular interventional radiological techniques have a growing role. ... In the case of prompt diagnosis and therapy, acute mesenteric ischemia can be reversible. ... Font VE, Hermann RE, Longworth DL (1989). "Chronic mesenteric venous thrombosis: difficult diagnosis and therapy". Cleveland ...
... This learning resource was developed by Medline Plus. Strokes can be caused by blood clots that travel to ... If you know the author of Thrombolytic Therapy, please help us out by filling out the form below and clicking Send. ... You just viewed Thrombolytic Therapy. Please take a moment to rate this material. ... Acceptance and Commitment Therapy in the treatment of anxiety: a systematic review ...
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 ...
When is thrombolytic therapy most effective?
Drugs & Diseases , Emergency Medicine , Thrombolytic Therapy Q&A When is thrombolytic therapy most effective?. Updated: Aug 04 ... Thrombolytic therapy with streptokinase in acute ischemic stroke. N Engl J Med. 1996 Jul 18. 335(3):145-50. [Medline]. ... Drip and ship thrombolytic therapy for acute ischemic stroke: use, temporal trends, and outcomes. Stroke. 2015 Mar. 46(3):732-9 ... Thrombolytic therapy for stroke in patients with preexisting cognitive impairment. Neurology. 2014 Jun 10. 82(23):2048-54. [ ...
What is thrombolytic therapy for middle cerebral artery (MCA) stroke?
Thrombolytic therapy should be administered in a very orchestrated and consistent manner, relying on emergent imaging and ... encoded search term (What is thrombolytic therapy for middle cerebral artery (MCA) stroke?) and What is thrombolytic therapy ... Thrombolytic therapy should be administered in a very orchestrated and consistent manner, relying on emergent imaging and ... What is thrombolytic therapy for middle cerebral artery (MCA) stroke?. Updated: Mar 17, 2020 ...
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 ... 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 ... The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same ...
Thrombolytic therapy facts, information, pictures | Encyclopedia.com articles about Thrombolytic therapy
Make research projects and school reports about Thrombolytic therapy easy with credible articles from our FREE, online ... and pictures about Thrombolytic therapy at Encyclopedia.com. ... Thrombolytic therapy. Definition. Thrombolytic therapy is the ... Thrombolytic Therapy. Definition. Thrombolytic therapy is the use of drugs that dissolve blood clots. ... Thrombolytic therapy uses drugs called thrombolytic agents, such as alteplase (Activase), anistreplase (Eminase), streptokinase ...
Thrombolytic Therapy in Acute Myocardial Infarction | SpringerLink
This paper deals with the history of thrombolytic therapy from its inception to its application in acute myocardial infarction ... Thrombolytic therapy with streptokinase. Australasian Annals of Medicine 19 (Suppl. 1), 1970Google Scholar ... Acute Myocardial Infarction Streptokinase Thrombolytic Therapy Plasmin Fibrinolytic Activity These keywords were added by ... Thrombolytic therapy followed by early revascularization for acute myocardial infarction. American Journal of Cardiology 57: ...
Thrombolytic Therapy | Providence
Thrombolytic Therapy (DVT). At Providence, were dedicated to treating the life-changing symptoms of deep vein thrombosis, ... Thrombolytic therapy, or thrombolysis for short, is the use of specific medications called thrombolytics to help break down ... During a catheter-directed thrombolytic treatment, a catheter (a thin, flexible tube) is inserted into your body (through a ... Once there, the tip of the catheter releases the thrombolytic drugs to help dissolve the clot. ...
Thrombolytic (Fibrinolytic) Therapy for Coronary Heart Disease | Circulation
Neonatal thrombosis and the thrombolytic system: pathophysiology and therapy. - PubMed - NCBI
Thrombolytic therapy is reviewed. It is recommended that future clinical studies be designed to include three essential ... Neonatal thrombosis and the thrombolytic system: pathophysiology and therapy.. Corrigan JJ Jr1. ... detailed studies of the newborns fibrinolytic mechanism before and during thrombolytic therapy. ... In older children and adults the use of thrombolytic drugs appears to be a promising medical approach to thromboembolic disease ...
Thrombolytic Therapy. Introduction | Stroke
Thrombolytic therapy - Scripps Health
Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks ... Reperfusion therapy, Stroke - thrombolytic, Heart attack - thrombolytic, Acute embolism - thrombolytic, Thrombosis - ... thrombolytic, Lanoteplase, Staphylokinase, Streptokinase (SK) or Urokinase. Definition. Thrombolytic therapy is the use of ... Thrombolytic therapy. Also known as: Tissue plasminogen activator, TPA, Alteplase, Reteplase, Tenecteplase, Activase ...
Pre-stroke Cognitive Status and Thrombolytic Therapy - Full Text View - ClinicalTrials.gov
Pre-stroke Cognitive Status and Thrombolytic Therapy (OPHELIE-COG). The safety and scientific validity of this study is the ... Influence of the Pre-existing Cognitive Status on the Outcome in Patients Treated by Thrombolytic Therapy for Acute Cerebral ... the only effective drug that increases the proportion of patients who survive without dependency is thrombolytic therapy by ...
Thrombolytic Therapy | Annals of Internal Medicine | American College of Physicians
The decision to withhold thrombolytic therapy, however, is based not only on the recognition of risk factors but also on our ... To the Editors: In their review of the selection of patients with acute myocardial infarction for thrombolytic therapy, Muller ... Review: In pulmonary embolism, thrombolytic therapy reduces all-cause mortality but increases major bleeding Annals of Internal ... Review: In pulmonary embolism, thrombolytic therapy reduces all-cause mortality but increases major bleeding Annals of Internal ...
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. [Medline] ... What is the indication for thrombolytic therapy in the acute management of stroke? ...
Experiences of Thrombolytic Therapy for Ischemic Stroke in Tuzla Canton, Bosnia and Herzegovina
Thrombolytic therapy is safe and leads to favorable outcome in half of the patients. ... To demonstrate our experiences of thrombolytic therapy in acute ischemic stroke. ,i ,Subjects and Methods,/i,. Patients with ... Experiences of Thrombolytic Therapy for Ischemic Stroke in Tuzla Canton, Bosnia and Herzegovina,. International Scholarly ... 24 hours after thrombolytic therapy. Half of patients (44/87) had a significant improvement within the first 24 hours, defined ...
Adjunctive treatment in patients treated with thrombolytic therapy | Heart
Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and ... Granger CB, Hirsch J, Califf RM, et al. Activated partial thromboplastin time and outcome after thrombolytic therapy for acute ... ADJUNCTIVE ANTITHROMBOTIC THERAPY. As stated before, the early and sustained success of fibrinolytic therapy is the result of ... mechanical reperfusion therapy has been proven to be even more beneficial than in-hospital initiated fibrinolytic therapy.w4 ...
Protective effect of intravenous magnesium in acute myocardial infarction following thrombolytic therapy. - PubMed - NCBI
The role of intravenous magnesium therapy in patients with acute myocardial infarction (AMI) who received thrombolytic therapy ... Intravenous magnesium sulphate in patients with AMI is a safe and useful adjunct to thrombolytic therapy in reducing the short- ... Protective effect of intravenous magnesium in acute myocardial infarction following thrombolytic therapy.. Raghu C1, Peddeswara ... All patients received magnesium immediately after the completion of thrombolytic therapy. Patients were followed up for 30 days ...
Hemorrhage After Thrombolytic Therapy for Stroke | Stroke
Hemorrhage After Thrombolytic Therapy for Stroke. The Clinically Relevant Number Needed to Harm. Jeffrey L. Saver ... Work Group on Thrombolytic Therapy in Stroke. WGoTTi. Position statement of the American Academy of Emergency Medicine on the ... novel derivation method and application to thrombolytic therapy for acute stroke. Arch Neurol. 2004; 61: 1066-1070. ... Intracranial hemorrhage associated with revascularization therapies. Stroke. 2007; 38: 431-440.. OpenUrlAbstract/FREE Full Text ...
Ns07 chronic subdural haematomas and anticoagulation or anti-thrombolytic therapy.
We suspected a high incidence of anticoagulant therapy or anti-thrombotic therapy in patients who presented with ... Purpose The use of anticoagulant therapy as a causative agent in the development of chronic subdural haematomas (CSDH) was ... We suspected a high incidence of anticoagulant therapy or anti-thrombotic therapy in patients who presented with CSDH. ... Purpose The use of anticoagulant therapy as a causative agent in the development of chronic subdural haematomas (CSDH) was ...
Thrombolytic Therapy vs. Anticoagulation for PE - Letters to the Editor - American Family Physician
"Is Thrombolytic Therapy Effective for Pulmonary Embolism?",1 and would like to comment on some points. Thrombolytic therapy ... thrombolytic therapy is effective for pulmonary embolism (PE). What remains debatable are the indications of thrombolytic ... 1. Almoosa K. Is thrombolytic therapy effective for pulmonary embolism? Am Fam Physician. 2002;65:1097-102.... ... Thrombolytic therapy of pulmonary embolism. A comprehensive review of current evidence. Chest. 1999;115:1695-707. ...
Thrombolytic Therapy for DVT (6 day treatment) | Medical Billing and Coding Forum - AAPC
1. Left leg venogram during thrombolytic therapy. 2. Vein angioplasty. 3. Catheter exchange during thrombolytic therapy. 4.. ... 1. Left leg venogram during thrombolytic therapy. 2. Vein angioplasty. 3. Catheter exchange during thrombolytic therapy. 4.. ... INITIATION OF THROMBOLYTIC THERAPY USING CATHETER- DIRECTED LOW DOSE TPA FROM AN ANTEGRADE LEFT COMMON FEMORAL VEIN APPROACH.. ... INITIATION OF THROMBOLYTIC THERAPY USING CATHETER- DIRECTED LOW DOSE TPA FROM AN ANTEGRADE LEFT COMMON FEMORAL VEIN APPROACH.. ...
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Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction:...
R. M. Califf, E. J. Topol, R. S. Stack et al., "Evaluation of combination thrombolytic therapy and timing of cardiac ... "Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and ... P. Kuhn, K. Atzenhofer-Baumgartner, F. Chmelizek et al., "Prehospital thrombolytic therapy in patients with suspected acute ... Risks and Benefits of Thrombolytic, Antiplatelet, and Anticoagulant Therapies for ST Segment Elevation Myocardial Infarction: ...
Very Early Thrombolytic Therapy in Suspected Acute Myocardial Infarction - American College of Cardiology
Very Early Thrombolytic Therapy in Suspected Acute Myocardial Infarction - TEAHAT. Mar 06, 2005 Share via: ... Very early thrombolytic therapy in suspected acute myocardial infarction. The Thrombolysis Early in Acute Heart Attack Trial ... Inability to give informed consent and contraindication to thrombolytic therapy. Primary Endpoints: Infarct size determined by ... Patients with a second episode of chest pain after therapy could receive an additional dose of the study medication. Heparin ...
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Targeting Therapeutics Across the Blood Brain Barrier (BBB), Prerequisite Towards Thrombolytic Therapy for Cerebrovascular...
Nakashima T, Minematsu K. Prospects of thrombolytic therapy for acute ischemic stroke. Brain Nerve. 2009;61(9):1003-12.PubMed ... Risk of thrombolytic therapy for acute ischemic stroke in patients with current malignancy. J Stroke Cerebrovasc Dis. 2011;20(2 ... Renal impairment reduces the efficacy of thrombolytic therapy in acute ischemic stroke. Cerebrovasc Dis. 2013;35(1):45-52. ... Early disruption of the blood-brain barrier after thrombolytic therapy predicts hemorrhage in patients with acute stroke. ...
Get PDF - Long term follow up after thrombolytic therapy
Long term follow up after thrombolytic therapy. Long term follow up after thrombolytic therapy. Lotan, C.; Gurevitch, J.; ... Is initial success of thrombolytic therapy with rt-PA in patients with lower limb ischemia durable? A long-term follow-up ... Effect of salvage PTCA on long-term follow-up of acute MI treated with thrombolytic therapy in the KAMIT study. Clinical ... Long-term follow-up of gender specific outcomes after thrombolytic therapy for acute myocardial infarction from the GUSTO-I ...
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thrombolytic therapy implications for patient management
... knowledge of thrombolytic medications so that they can identify the optimal therapy and safely use these medications. ... Specific knowledge of the general information and caveats associated with thrombolytic therapy is vital for optimal patient ... knowledge of thrombolytic medications so that they can identify the optimal therapy and safely use these medications. ... His clinical experience has focused on caring for adult patients with advanced heart disease who require mechanical therapies ...
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- Thrombolytic therapy should be administered in a very orchestrated and consistent manner, relying on emergent imaging and screening to ensure only patients with ischemic stroke and no contraindications receive such therapy. (medscape.com)
- Current treatments for acute ischemic stroke include IV thrombolytic therapy with tissue-type plasminogen activator ( t-PA ) and endovascular therapies using stent retriever devices. (medscape.com)
- [ 5 ] . A 2015 update of the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke recommends that patients eligible for intravenous t-PA should receive intravenous t-PA even if endovascular treatments are being considered and that patients should receive endovascular therapy with a stent retriever if they meet criteria. (medscape.com)
- To demonstrate our experiences of thrombolytic therapy in acute ischemic stroke. (hindawi.com)
- We present our results of thrombolytic therapy in acute ischemic stroke reffering to demographic information, time parameters, and clinical outcome. (hindawi.com)
- Thrombolysis with intravenous(iv) tissue plasminogen activator (t-PA) is the only effective and approved therapy for acute ischemic stroke. (clinicaltrials.gov)
- Thrombolytic therapy commonly is used to treat an ischemic stroke, which is another name for a clot in a blood vessel in your brain. (indiasurgerytour.com)
- Background and Purpose- Several definitions have been proposed to distinguish clinically relevant from incidental cerebral hemorrhagic transformation after thrombolytic therapy for acute ischemic stroke. (medworm.com)
- Timeliness of tissue-type plasminogen activator therapy in acute ischemic stroke: patient characteristics, hospital factors, and outcomes associated with door-to-needle times within 60 minutes. (springermedizin.de)
- Mechanisms of hemorrhagic transformation after tissue plasminogen activator reperfusion therapy for ischemic stroke. (springermedizin.de)
- 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. (eestiarst.ee)
- Only the rt-PA, synthesised in 1980s, has reached the clinical practice and is used for the thrombolytic treatment of acute ischemic stroke. (eestiarst.ee)
- Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). (readbyqxmd.com)
- Objectives: This article provides recommendations on the use of antithrombotic therapy in patients with stroke or transient ischemic attack (TIA). (nuigalway.ie)
- In patients with a history of noncardioembolic ischemic stroke or TIA, we recommend long-term treatment with aspirin (75-100 mg once daily), clopidogrel (75 mg once daily), aspirin/extended release dipyridamole (25 mg/200 mg bid), or cilostazol (100 mg bid) over no antiplatelet therapy (Grade 1A), oral anticoagulants (Grade 1B), the combination of clopidogrel plus aspirin (Grade 1B), or triflusal (Grade 2B). (nuigalway.ie)
- Hemorrhagic transformation (HT) is a common complication of ischemic stroke that is often exacerbated by reperfusion with alteplase (recombinant tissue plasminogen activator) or endovascular therapy (EVT) ( 1 ). (frontiersin.org)
- Race/Ethnic differences in the risk of hemorrhagic complications among patients with ischemic stroke receiving thrombolytic therapy. (duke.edu)
- Future studies are needed to evaluate whether reduction in tPA dose similar to that used in many Asian countries could improve the safety of tPA therapy in Asians in the United States with acute ischemic strokes while maintaining efficacy. (duke.edu)
- Osborn and associates reviewed the large trials of thrombolytic therapy in the treatment of patients with ischemic stroke. (aafp.org)
- Thrombolytic therapy uses drugs called thrombolytic agents, such as alteplase (Activase), anistreplase (Eminase), streptokinase (Streptase, Kabikinase), urokinase (Abbokinase), and tissue plasminogen activator (TPA) to dissolve clots. (encyclopedia.com)
- Anticoagulants plus streptokinase therapy in progressive stroke. (springer.com)
- CONCLUSION: In STEMI patients treated with thrombolytic agents (predominantly streptokinase), fondaparinux significantly reduced the risk of death, re-MI and severe bleeds. (diva-portal.org)
- The thrombolytic agents studied include streptokinase, urokinase, recombinant pro-urokinase and recombinant tissue plasminogen activator (rt-PA). (eestiarst.ee)
- Thrombolytic agents including streptokinase, urokinase and tPA as well as a number of recombinant tPA derivatives with modified properties. (oncohemakey.com)
- Thrombolytic therapy was administered as an intravenous infusion of streptokinase or urokinase , initially at a loading dose of 2.5L IU/hour over 30 minutes, followed by 1L IU/hour for 48-78 hours depending upon the clinical and 2D-Echo observation . (bvsalud.org)
- Thrombolytic therapy, or thrombolysis for short, is the use of specific medications called thrombolytics to help break down blood clots within major arteries. (providence.org)
- Depending upon the situation, your physician may decide to provide thrombolytic therapy, also called thrombolysis, as an emergency treatment or as a scheduled procedure to dissolve the blood clots. (indiasurgerytour.com)
- Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency. (veinforum.org)
- Comment: Successful thrombolysis for DVT was associated with significantly better QOL than failed thrombolysis or anticoagulant therapy for acute iliofemoral DVT. (veinforum.org)
- CONCLUSION Generation of thrombin, occurring during thrombolysis, is a major determinant for the success of therapy and thrombin-antithrombin III levels may serve as predictors for the short-term prognosis. (ahajournals.org)
- In Chapter 1, I introduce ischaemic stroke, thrombolytic therapy, thrombolysis trials and then discuss the rationale for exclusion criteria in stroke thrombolysis guidelines.In Chapter 2, I describe methods for examining outcomes in patients that are currently recommended for exclusions from receiving alteplase for acute ischaemic stroke. (gla.ac.uk)
- Anticoagulation is the mainstay of therapy for most patients, with thrombolytic therapy reserved for some patients.1 Recent studies have suggested a role for systemic or catheter-directed thrombolytic therapy in selected patients.2 We present a case of a patient who presented with an PE, was successfully treated with catheter-directed thrombolysis. (readbyqxmd.com)
- We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery. (readbyqxmd.com)
- 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 have a contraindication to thrombolysis and, therefore, not receive thrombolytic therapy (122). (78stepshealth.us)
- Factors associated with increased risk of HT include stroke severity, reperfusion therapy (thrombolysis and thrombectomy), hypertension, hyperglycemia, and age. (frontiersin.org)
- Thrombolytic therapy can be used as the first-line treatment for thrombolysis in PVT patients . (bvsalud.org)
- 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)
- Now extensively revised and significantly expanded, this second edition of the highly praised Thrombolytic Therapy for Stroke incorporates the knowledge gained from the widespread implementation of large rt-PA for acute stroke trials and demonstrates the power of the new technologies now available, specifically MRI scanning. (springer.com)
- The authors, all recognized experts internationally known for their contributions to developing thrombolytic therapy, have included much new material on stroke-MRI and computed tomography, and updated all chapters describing the background, use, and nuances of thrombolytic therapy. (springer.com)
- Practical how-to chapters guide the reader in treating acute stroke patients, both with and without thrombolytic therapy, according to the latest findings. (springer.com)
- Up to date and highly practical, Thrombolytic Therapy for Acute Stroke, Second Editon offers the practicing physician everything necessary-background, protocols, new technologies, and case studies-for the safe and effective treatment of the emergency stroke patient today. (springer.com)
- What is thrombolytic therapy for middle cerebral artery (MCA) stroke? (medscape.com)
- Research suggests that when used to treat stroke, thrombolytic therapy can prevent or reverse paralysis and other problems that otherwise might result. (encyclopedia.com)
- For thrombolytic therapy to be effective in treating stroke or heart attack, prompt medical attention is very important. (encyclopedia.com)
- Serial monitoring and interventions when necessary early in the clinical course and eventual stroke rehabilitation and physical and occupational therapy are the ideals of management. (medscape.com)
- Newer stroke trials have explored the benefit of using neuroimaging to select patients who are most likely to benefit from thrombolytic therapy and the potential benefits of extending the window for thrombolytic therapy beyond the guideline of 3 hours with t-PA and newer agents. (medscape.com)
- You may be a candidate for thrombolytic therapy if you have symptoms of a stroke, heart attack, pulmonary embolism, DVT, or a clot in an artery or bypass graft in a limb. (indiasurgerytour.com)
- Zeumer H, Freitag H-J, Zanella F, Thise A, Arning C. Local intra-arterial thrombolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (rt-PA). (springer.com)
- del Zoppo G, Zeumer H, Harker LA. Thrombolytic therapy in stroke: Possibilities and hazards. (springer.com)
- Abstract Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischaemic stroke has been associated with neurotoxicity, blood brain barrier (BBB) disruption and intra-cerebral hemorrhage. (medworm.com)
- Age alone should not be a criterion for excluding patients from receiving thrombolytic therapy.In Chapter 5, I employ VISTA data to examine whether patients having diabetes and previous stroke have improved outcomes from use of alteplase in acute ischaemic stroke. (gla.ac.uk)
- 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. (springermedizin.de)
- Sera from acute stroke patients and rats with thrombolytic therapy were collected to investigate HMGB1 secretion. (springermedizin.de)
- In real world practice, patients with minor stroke symptoms are still treated with thrombolytic therapy and majority of them recover with favorable outcomes at 90 days, but there is room to identify avenues to further enhance their outcomes. (ovid.com)
- In patients with a history of stroke or TIA and atrial fibrillation we recommend oral anticoagulation over no antithrombotic therapy, aspirin, and combination therapy with aspirin and clopidogrel (Grade 1B). (nuigalway.ie)
- Thrombolytic therapy for acute stroke in late pregnancy with intra-arterial recombinant tissue plasminogen activator. (elsevier.com)
- Fingerprint Dive into the research topics of 'Thrombolytic therapy for acute stroke in late pregnancy with intra-arterial recombinant tissue plasminogen activator. (elsevier.com)
- Furthermore, the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) study revealed a trend toward lower total stroke rate and 30-d mortality in female patients over 75 yr of age treated with tenecteplase than in those treated with alteplase. (78stepshealth.us)
- Since the National Institute of Neurologic Disorders and Stroke (NINDS) study ( 1 ) was done, intravenous (IV) recombinant tissue plasminogen activator (rTPA) therapy within 3 hours after the onset of symptoms has been widely used. (ajnr.org)
- Specific parameters from the studies include (1) thrombolytic agent administered, (2) interpretation of computed tomographic (CT) scans before initiation of treatment, (3) time between stroke-symptom onset and therapy administration, (4) dose of thrombolytic agent, (5) use of ancillary medication and (6) blood pressure. (aafp.org)
- The use of ancillary medication (e.g., antiplatelet drugs and anticoagulants) in conjunction with thrombolytic therapy appears to be unwise in patients within 24 hours after a stroke, although further research is needed to examine this point. (aafp.org)
- Intravenous thrombolytic therapy for stroke: a review of recent studies and controversies. (aafp.org)
- Further therapy, such as cardiac catheterization with angioplasty and stenting, may be needed. (medlineplus.gov)
- Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction. (annals.org)
- Low risk patients (n = 95) were randomized to primary angioplasty or thrombolytic therapy. (onlinejacc.org)
- Primary angioplasty, defined as angioplasty for acute myocardial infarction without prior or concomitant thrombolytic therapy, results in a higher patency rate of the infarct-related vessel, smaller enzymatic infarct size, better preserved left ventricular function and better clinical outcome when compared with intravenous thrombolytic therapy ( [1-4] ). (onlinejacc.org)
- Previous studies ( [1, 7, 13] ) have shown that the increased benefit of primary angioplasty over that of thrombolytic therapy has been found in particular in high risk patients but is less certain in low risk patients. (onlinejacc.org)
- Therefore, we randomized patients at low risk to thrombolytic therapy or primary angioplasty. (onlinejacc.org)
- After Thrombolytic Therapy: Angiography, Angioplasty, or Surge. (mysciencework.com)
- Many investigators advocate that combined emergency coronary angiography and percutaneous transluminal coronary angioplasty be performed immediately after thrombolytic therapy. (mysciencework.com)
- Therefore, it is probable that most patients with evolving Q-wave myocardial infarction are best treated with conservative strategies after initial thrombolytic therapy, although there may still be a role for emergency angioplasty in a relatively small subset who present with evolving myocardial infarction and severely depressed left ventricular function. (mysciencework.com)
- Patients with cardiogenic shock, left bundle branch block, prior aortocoronary bypass surgery, recent percutaneous transluminal coronary angioplasty or standard contraindications to thrombolytic therapy were excluded. (duke.edu)
- The hepatic venous outflow obstruction was relieved by angioplasty and thrombolytic therapy with use of local infusions of urokinase into the clot. (elsevier.com)
- We propose that angiography be performed in patients in whom the Budd-Chiari syndrome is suspected and that angioplasty and thrombolytic therapy be initiated early. (elsevier.com)
- Percutaneous revascularization strategies to restore coronary artery patency during acute myocardial infarction in the absence of prior thrombolytic therapy, or primary angioplasty, results in a higher infarct-related coronary artery patency rate (131), smaller enzymatic infarct size, increased preservation of left ventricular function, and improved clinical outcome compared to thrombolytic therapy (131-133). (78stepshealth.us)
- Thrombolytic therapy for submassive pulmonary embolus? (bmj.com)
- We read with interest Dr. Almoosa's article, "Is Thrombolytic Therapy Effective for Pulmonary Embolism? (aafp.org)
- 2 So, the answer to the title question is, yes, thrombolytic therapy is effective for pulmonary embolism (PE). (aafp.org)
- Dr. Almoosa states that no evidence from clinical trials proves thrombolytic therapy reduces the recurrence rate of pulmonary embolism or affects mortality better than anticoagulation. (aafp.org)
- 1. Almoosa K. Is thrombolytic therapy effective for pulmonary embolism? (aafp.org)
- Thrombolytic therapy of pulmonary embolism. (aafp.org)
- Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. (aafp.org)
- Catheter directed thrombolytic therapy and aspiration thrombectomy in intermediate pulmonary embolism with long term results. (medworm.com)
- The incidence of pulmonary embolism, deep venous thrombosis, major bleeding (MB), clinically relevant non-MB, acute respiratory distress syndrome, and in-hospital mortality was compared between patients on fondaparinux versus enoxaparin therapy. (medworm.com)
- What are the risks and benefits of thrombolytic therapy in the management of patients with acute pulmonary embolism (PE)? (acc.org)
- For patients with PE and haemodynamic instability, offer UFH and consider thrombolytic therapy (see recommendations 1.2.7 and 1.2.8 on pharmacological systemic thrombolytic therapy in pulmonary embolism). (nice.org.uk)
- Thrombolytic therapy in pulmonary embolism is a topic covered in the Evidence-Based Medicine Guidelines . (unboundmedicine.com)
- Evidence Central , evidence.unboundmedicine.com/evidence/view/EBMG/452334/all/Thrombolytic_therapy_in_pulmonary_embolism. (unboundmedicine.com)
- Ns07 chronic subdural haematomas and anticoagulation or anti-thrombolytic therapy. (biomedsearch.com)
- The authors did a systematic review of randomized controlled studies comparing systemic thrombolytic therapy plus anticoagulation with anticoagulation alone in patients with acute PE. (acc.org)
- The article describes the antithrombotic effect of VKAs, the monitoring of anticoagulation intensity, the clinical applications of VKA therapy, and the optimal therapeutic range of VKAs, and provides specific management recommendations. (sigmaaldrich.com)
- Among the key recommendations in this article are the following: for dosing of VKAs, we suggest the initiation of oral anticoagulation therapy with doses between 5 and 10 mg for the first 1 or 2 days for most individuals, with subsequent dosing based on the international normalized ratio (INR) response (Grade 2B). (sigmaaldrich.com)
- If a whole‑leg scan is conducted initially, no repeat ultrasound at 1 week is required, but more patients may need anticoagulation therapy. (nice.org.uk)
- Determining whether LMWH or a VKA should be used for anticoagulation treatment in patients with cancer beyond the initial 6 months of LMWH therapy is critically important. (nice.org.uk)
- 2 This article reviews updates to thrombolytic, antiplatelet, and anticoagulation therapies, statin use, blood pressure and blood glucose targets, and a new recommendation for depression screening. (uspharmacist.com)
Deep vein throm1
- Therapy may take one to 48 hours, depending on whether you've had a heart attack or have deep vein thrombosis (DVT). (emoryhealthcare.org)
- High-dose intravenous thrombolytic therapy in acute myocardial infarction: efficiency, tolerance, complications and influence on left ventricular performance. (biomedsearch.com)
- MyMediTravel currently has no pricing information available for Intravenous Thrombolytic Therapy procedures in Wiesbaden. (mymeditravel.com)
- HELIOS DKD Hospital Wiesbaden, located in Aukammallee, Wiesbaden, Germany offers patients Intravenous Thrombolytic Therapy procedures among its total of 255 available procedures, across 23 different specialties. (mymeditravel.com)
- Currently, there's no pricing information for Intravenous Thrombolytic Therapy procedures at HELIOS DKD Hospital Wiesbaden, as all prices are available on request only. (mymeditravel.com)
- Then you should expect to rest for a few more days before you begin to commence light activity again - remember, Intravenous Thrombolytic Therapy is a major surgery and your body needs time to recover. (mymeditravel.com)
- The success rate for Intravenous Thrombolytic Therapy in Wiesbaden is now extremely high given the recent advances in medical technology and surgeon experience. (mymeditravel.com)
- Intravenous Thrombolytic Therapy at Clinique de Ge. (mymeditravel.com)
- It is 0 Km away from the City and was established in 1972 Jan. Feel free to request a free quote and our team will compare the prices and costs for Intravenous Thrombolytic Therapy in Witellikerstrasse and create a shortlist of the most suitable clinics. (mymeditravel.com)
- Intravenous Thrombolytic Therapy at Bumrungrad Int. (mymeditravel.com)
- Intravenous Thrombolytic Therapy at Pantai Hospita. (mymeditravel.com)
- Koc University Hospital is offering Intravenous Thrombolytic Therapy procedures and the prices range between $846 and $1,017. (mymeditravel.com)
- Intravenous Thrombolytic Therapy in and around Leb. (mymeditravel.com)
- Intravenous Thrombolytic Therapy at Medicana Inter. (mymeditravel.com)
- Purpose The use of anticoagulant therapy as a causative agent in the development of chronic subdural haematomas (CSDH) was investigated. (biomedsearch.com)
- We suspected a high incidence of anticoagulant therapy or anti-thrombotic therapy in patients who presented with CSDH. (biomedsearch.com)
- We found that anticoagulant therapy was used by a significant percentage of CSDH patients. (biomedsearch.com)
- In patients undergoing dental procedures, we suggest the use of tranexamic acid mouthwash (Grade 2B) or epsilon amino caproic acid mouthwash without interrupting anticoagulant therapy (Grade 2B) if there is a concern for local bleeding. (sigmaaldrich.com)
- Since the effects of warfarin anticoagulant therapy were insufficient, its dose was adjusted on follow-up. (umin.ac.jp)
- immediate interim parenteral anticoagulant therapy followed by a CTPA, if a CTPA cannot be carried out immediately. (nice.org.uk)
- Most patients who have bleeding can be managed by interruption of thrombolytic and anticoagulant therapy, volume replacement, and manual pressure applied to an incompetent vessel. (scripps.edu)
Acute myocardial infarction f1
- Protective effect of intravenous magnesium in acute myocardial infarction following thrombolytic therapy. (nih.gov)
- Although such therapy appears to reduce mortality from cardiac causes, our data do not definitely establish that it reduces overall mortality. (nih.gov)
- Intravenous magnesium sulphate in patients with AMI is a safe and useful adjunct to thrombolytic therapy in reducing the short-term mortality and ventricular arrhythmias after AMI. (nih.gov)
- 3 A recent trial 6 that evaluated 719 patients with right ventricular dysfunction reported a 30-day mortality of 11.1 percent in the anticoagulant group, compared with 4.7 percent in the thrombolytic group. (aafp.org)
- Thrombolytic therapy reduces total mortality, PE recurrence, and PE-related mortality in patients with acute PE. (acc.org)
- Another recent meta-analysis focused on the impact of right ventricular (RV) dysfunction on outcome and concluded that those with hemodynamically stable PE and RV dysfunction benefit from thrombolytic therapy with a meaningful reduction in overall mortality, but with a significant risk of major bleeding including intracranial hemorrhage, particularly in patients older than 65 years. (acc.org)
- AIMS: No antithrombotic therapy has been shown to reduce mortality when used with thrombolytics in acute myocardial infarction (AMI). (diva-portal.org)
- Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction. (semanticscholar.org)
- 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. (kingston.ac.uk)
- In a meta-analysis of the Fibrinolytic Therapy Trialists' Collaboration Group, which included all randomized clinical trials that compared thrombolytic agents with a placebo or control group, the absolute benefit of thrombolytic therapy with regard to 35-d mortality was 2.2% in female patients compared to 1.9% in male patients. (78stepshealth.us)
- Although studies have suggested that there may be an increase in the risk of moderate bleeding in menstruating patients treated with thrombolytic agents, the GUSTO-I study revealed that the mortality reduction associated with thrombolytic therapy for acute myocardial infarction should not be withheld because of active menstruation (130). (78stepshealth.us)
- 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. (aafp.org)
- This paper deals with the history of thrombolytic therapy from its inception to its application in acute myocardial infarction. (springer.com)
- The efficacy of thrombolytic therapy for acute myocardial infarction depends partly on how soon after the onset of symptoms it is administered. (nih.gov)
- We therefore studied the efficacy and safety of thrombolytic therapy administered before hospital admission and thrombolytic therapy administered after admission in patients with suspected myocardial infarction. (nih.gov)
- 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. (nih.gov)
- In their review of the selection of patients with acute myocardial infarction for thrombolytic therapy, Muller and Topol (1) pointed out the current limitations in applying this therapy to a larger number of patients. (annals.org)
- The decision to withhold thrombolytic therapy, however, is based not only on the recognition of risk factors but also on our inability to make an accurate and timely diagnosis of an acute myocardial infarction (2). (annals.org)
- Consequently, the majority of patients with ST elevation myocardial infarction receive fibrinolytic therapy. (bmj.com)
- The role of intravenous magnesium therapy in patients with acute myocardial infarction (AMI) who received thrombolytic therapy is controversial. (nih.gov)
- As with acute myocardial infarction, one would expect that a larger (more than 1,000 patients) randomized multicenter study will eventually give the definitive indications for thrombolytic therapy in such patients. (aafp.org)
- Increased thrombin levels during thrombolytic therapy in acute myocardial infarction. (ahajournals.org)
- In patients with acute myocardial infarction (MI) after failed thrombolytic therapy, does rescue percutaneous coronary intervention (PCI) reduce cardiovascular and cerebrovascular events? (annals.org)
- Enzymatic evidence of impaired reperfusion in diabetic patients after thrombolytic therapy for acute myocardial infarction: a role for plasminogen activator inhibitor? (bmj.com)
- OBJECTIVE--To compare the activity of plasminogen activator inhibitor (PAI-1) in diabetic and non-diabetic patients admitted with acute myocardial infarction and to determine whether PAI-1 activity influences reperfusion after thrombolytic therapy. (bmj.com)
- To compare a system of prehospital thrombolytic therapy, delivered by paramedics under medical guidance, with in-hospital thrombolytic therapy in meeting National Service Framework (NSF) targets for treatment of acute myocardial infarction at a District General Hospital setting in England. (bmj.com)
- Retrospective observational case-control study comparing patients with suspected acute myocardial infarction (AMI) treated with thrombolytic therapy in the prehospital environment with patients treated in hospital. (bmj.com)
- 3. Myocardial infarction was confirmed in 92% (25/27) of patients who received prehospital thrombolytic therapy and similarly 92% (25/27) of those given in-hospital thrombolytic therapy. (bmj.com)
- In a period of 18 months, 2,469 patients with acute myocardial infarction treated with a thrombolytic agent were prospectively registered in 61 hospitals. (semanticscholar.org)
- The aim of the study was to determine the in-hospital delay in administrating thrombolytic therapy to patients with acute myocardial infarction (AMI) A mixed method with convergent parallel design was applied to the study. (sun.ac.za)
- The population consisted of N=63 case notes of adult patients diagnosed with acute myocardial infarction and who had received thrombolytic therapy. (sun.ac.za)
- Thrombolytic agents have become the corner stone in the treatment of acute myocardial infarction. (semanticscholar.org)
- The outcome of in-hospital patients with myocardial infarction with and without diabetes after thrombolytic therapy is presented here. (readbyqxmd.com)
- Thrombolytic therapy has been found to improve the prognosis of selected patients with acute myocardial infarction. (mysciencework.com)
- Graded exercise testing following thrombolytic therapy for acute myocardial infarction: the importance of timing and infarct location. (duke.edu)
- OBJECTIVES: To determine the influence of timing, infarct location and thrombolytic therapy on the electrocardiographic (ECG) response to exercise testing following acute myocardial infarction. (duke.edu)
- Thrombolytic therapy is being used with increasing frequency to treat acute myocardial infarction (MI). (elsevier.com)
- Quinn, T. and Thompson, D.R. (1995) Administration of thrombolytic therapy to patients with acute myocardial infarction. (kingston.ac.uk)
- Conclusion: Adjunctive stenting following thrombolytic administration in AMI improves epicardial TIMI 3 flow and TIMI frame counts as well as dye inflow into the myocardium: TMPG 0 is reduced and myocardial blush measured quantitatively by DSA tends to be brighter. (elsevier.com)
- In contrast to these observations, a recent retrospective review of women age 50 yr or younger, who presented with an acute myocardial infarction, determined that 94% of women met eligibility criteria for thrombolytic agents, and 91% of these women were treated with drug. (78stepshealth.us)
History of thrombolytic therapy1
- Ouriel K. A history of thrombolytic therapy. (medscape.com)
Delivery of thrombolytic therapy2
Administration of thrombolytic therapy1
- Further study is also needed to determine the upper limit of blood pressure that would exclude the administration of thrombolytic therapy. (aafp.org)
- Combined intravenous (IV) and intra-arterial (IA) thrombolytic therapy may be faster and easier to initiate than monotherapy, and its recanalization rate may be better as well. (ajnr.org)
Early Thrombolytic Therapy1
- Time gains are substantial and can meet the national targets for early thrombolytic therapy in the majority of patients. (bmj.com)
- In addition, female gender and low body weight were identified as independent risk factors for cerebrovascular and hemorrhagic complications associated with thrombolytic therapy (128). (78stepshealth.us)
- Complications in thrombolytic therapy are not uncommon, so that is why it is done under close supervision. (vasculartyler.com)
- It is recommended that future clinical studies be designed to include three essential features: (a) a uniform clinical staging, (b) a dose-response relationship with a plasminogen activator based on in vivo and in vitro studies, and (c) detailed studies of the newborn's fibrinolytic mechanism before and during thrombolytic therapy. (nih.gov)
- w3 With improvements in techniques and experience, mechanical reperfusion therapy has been proven to be even more beneficial than in-hospital initiated fibrinolytic therapy. (bmj.com)
- In the first part of this comprehensive review of thrombolytic therapy in clinical medicine, we begin with a brief history of fibrinolysis, followed by a review of the components of die endogenous fibrinolytic system and the currently available plasminogen activators. (elsevier.com)
- During a catheter-directed thrombolytic treatment, a catheter (a thin, flexible tube) is inserted into your body (through a small incision, often in the leg) and carefully guided to the specific point in the vein where the clot is located. (providence.org)
- Once there, the tip of the catheter releases the thrombolytic drugs to help dissolve the clot. (providence.org)
- 2. Initiation of thrombolytic therapy using catheter- directed TPA. (aapc.com)
- The catheter with multiple sideholes is positioned to deliver thrombolytic therapy within the thrombus as described. (aapc.com)
- 2. Catheter exchange during thrombolytic therapy. (aapc.com)
- Thrombolytic therapy involves inserting a catheter into an artery in the groin and threading to the site of the clot. (mercy.com)
- Thrombolytic therapy is safe and leads to favorable outcome in half of the patients. (hindawi.com)
- To evaluate the outcome of intraventricular thrombolytic therapy for intraventricular haemorrhage and to formulate a safe and effective regimen. (hkmj.org)
- The critical event is usually the formation of an acute thrombus, so the rationale for thrombolytic treatment is to achieve arterial recanalization with a relatively safe agent soon enough to improve patient outcome. (springer.com)
- Materials and Methods: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. (medworm.com)
- Thrombolytic therapy is the use of drugs that dissolve blood clots. (encyclopedia.com)
- Thrombolytic therapy is used to dissolve blood clots that could cause serious, and possibly life-threatening, damage if they are not removed. (encyclopedia.com)
- Thrombolytic therapy is also used to dissolve blood clots that form in catheters or tubes put into people's bodies for medical treatments, such as dialysis or chemotherapy. (encyclopedia.com)
- Although in most cases thrombolytic therapy will alleviate your symptoms and dissolve the blood clot, there are cases where the treatment is not effective. (mercy.com)
- In thrombolytic therapy, clot-busting drugs called lytics dissolve blood clots that suddenly block major blood vessels. (emoryhealthcare.org)
- Thrombolytic therapy, also known as lysis therapy, is emergency treatment for patients who have completely blocked arteries or veins caused by blood clots. (mercy.com)
- Birth control pills, hormone replacement therapy , and other medications that contain estrogen can also increase the risk of blood clots. (medicalnewstoday.com)
- Thrombolytic therapy is used to treat dangerous blood clots found in veins and arteries. (vasculartyler.com)
- w4 Yet, pharmacological reperfusion therapy is more widely available, more easily applicable, and less dependent of institutional experience. (bmj.com)
- In order to optimise the efficacy of reperfusion therapy, concomitant thrombin and platelet inhibition is required, which is aimed not only at enhancing early patency but also for reducing reocclusion and recurrent thrombotic events. (bmj.com)
- In this review, we present the relationship of inflammation and immune activation to HT in the context of reperfusion therapy, hypertension, hyperglycemia, and age. (frontiersin.org)
- This may be the case when reperfusion therapy improves the NIHSS and offsets potential worsening caused by HT. (frontiersin.org)
- 7 Multiple substudies of recent large RCTs of dual antiplatelet therapy have shown similar efficacy and lower rates of bleeding for low-dose compared with higher-dose ASA. (cmaj.ca)
- What additional antiplatelet therapy should be given? (cmaj.ca)
- Major advances were made to antiplatelet therapy with the approval of 2 new agents, prasugrel and ticagrelor, which both have a more rapid, predictable and potent antiplatelet effect than clopidogrel ( Table 1 ). (cmaj.ca)
- Aspirin is reaffirmed as the drug of choice for antiplatelet treatment of AIS, and recommendations regarding dual antiplatelet therapy for secondary prophylaxis are updated. (uspharmacist.com)
- 7 The new guidelines specify that IV alteplase should be administered to patients receiving antiplatelet monotherapy and dual antiplatelet therapy (DAPT), although administration with DAPT has a lower quality of evidence. (uspharmacist.com)
- Anticoagulant and antithrombotic therapy is given to prevent formation or propagation of thrombi. (oncohemakey.com)
Criteria for thrombolytic1
- Eligibility criteria for thrombolytic trials have usually relied on a typical history of chest pain and specific electrocardiographic (ECG) findings of acute ischemia. (annals.org)
- 2 Right ventricular dysfunction clearly defines patients at high risk for clinical deterioration, and these patients are excellent candidates for thrombolytic therapy. (aafp.org)
- His clinical experience has focused on caring for adult patients with advanced heart disease who require mechanical therapies or cardiac transplantation. (westernschools.com)
- Nonsignificant decreases in fibrinogen levels were observed while D-dimer levels increased +3,008 +/- 4,047 micrograms/l (p less than 0.01), differences not being significant in respect to the thrombolytic agents or to the clinical course. (ahajournals.org)
- Intracranial hemorrhage in association with thrombolytic therapy: incidence and clinical predictive factors. (semanticscholar.org)
- The median time interval between the start of thrombolytic therapy and the first clinical signs of intracranial bleeding was 16 h (range 3 to 36). (semanticscholar.org)
- Bell, WR & Streiff, MB 1993, ' Thrombolytic Therapy: A Comprehensive Review of its Use in Clinical Medicine - Part i ', Journal of Intensive Care Medicine , vol. 8, no. 2, pp. 56-72. (elsevier.com)
- The name "thrombolytic" comes from two Greek words that mean "clot" and "loosening. (encyclopedia.com)
- Thrombolytic therapy only removes the clot, but it can be administered in hospitals with fewer resources than are required for insertion of a stent. (encyclopedia.com)
- These hemorrhagic strokes have been blocked by clots that would be broken up by use of a thrombolytic agent, so that removal of the harmful clot would cause equally dangerous bleeding. (encyclopedia.com)
- Thrombolytic therapy results in more clot lysis than treatment with heparin alone. (aafp.org)
- Recovery time from thrombolytic therapy depends greatly on the severity of the clot as well as any possible underlying condition that may have caused the clot. (vasculartyler.com)
- Ideally, you should receive thrombolytic medicines within the first 30 minutes after arriving at the hospital for treatment. (medlineplus.gov)
- Early trials have limited relevance in the era of modern thrombolytic agents. (aafp.org)
- Careful examination of individual thrombolytic trials to discern differences might indicate a particularly beneficial treatment protocol. (aafp.org)
- A dose of 0.9 mg per kg of tPA demonstrated efficacy and served as the standard regimen in all of the trials using this thrombolytic agent. (aafp.org)
- Thrombolytic therapy is a treatment used to break up dangerous clots inside your blood vessels. (indiasurgerytour.com)
- Thrombolytic therapy is less risky than treatment with blood-thinning medications such as warfarin and heparin. (mercy.com)
- In rural communities, however, where transfer times are often in excess of 30 minutes, the NSF document acknowledged that other models of care such as prehospital thrombolytic therapy might offer the best access to early treatment. (bmj.com)
- In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. (readbyqxmd.com)
- Thrombolytic treatment is administered intravenously in a single injection or as a slow infusion for a few hours, thereafter, treatment continues with anticoagulants. (trombo.info)
- Recent advances include use of computerized tomography angiography (CTA) for prompt diagnosis, sophisticated methods such as local thrombolytic therapy (LTT) for treatment and laparoscopy for both. (biomedcentral.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)
- Treatment of young women with thrombolytic therapy was previously thought to be problematic owing to the increased risk of hemorrhage associated with active menstruation. (78stepshealth.us)
- Despite the advantage of the rapid and easy initiation of thrombolytic therapy, IV rTPA treatment is limited by low recanalization rates, particularly in larger proximal arterial occlusions ( 2 , 3 ). (ajnr.org)
- Therefore, this study aimed to evaluate the efficacy and safety of thrombolytic treatment in PVT patients . (bvsalud.org)
- For patients with a high risk of thromboembolism, we suggest stopping warfarin therapy approximately 4 days before surgery, to allow the INR to return to normal, and beginning therapy with full-dose unfractionated heparin or full-dose low-molecular-weight heparin as the INR falls (Grade 2C). (sigmaaldrich.com)
- However, the patient complained of chest pain 1 h 30 min after initiation of thrombolytic therapy. (umin.ac.jp)
- One small trial 5 has shown a dramatic survival advantage favoring thrombolytic therapy in patients with massive PE and systemic hypoperfusion. (aafp.org)
- In this study, we sought to find a relation between the infarct size and the change in the QRS axis after thrombolytic therapy.Materials and Methods: Patients with STEAMI who received thrombolytic therapy were selected retrospectively. (oalib.com)
- However, in the isolated inferior MI group, there was a good correlation between CKMB and change in the QRS axis (r=-0.52 p=0.049).Conclusion: The change in the QRS axis is rarely emphasized, providing a practical and promising tool for evaluating both the efficiency of the thrombolytic therapy and prognostic infarct sizing. (oalib.com)
- Some thrombolytic agents may not work properly in people who have just had a strep infection, so the physician may want to use a different drug. (encyclopedia.com)
- What remains debatable are the indications of thrombolytic agents in PE. (aafp.org)
- In urban areas it may be possible to meet this target by rapid transfer and early administration of thrombolytic agents in hospital. (bmj.com)
- All the thrombolytic agents are the activators of plasminogen, which convert the proenzyme plasminogen to plasmin. (eestiarst.ee)
- 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. (kingston.ac.uk)
- However, there is insufficient data regarding the safety and activity of thrombolytic agents in cancer patients receiving bevacizumab-based therapy. (nih.gov)
- However, the combined use of thrombolytic agents with different mechanisms may have an additive and/or complementary effect. (ajnr.org)
- The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same thing. (medlineplus.gov)
- In older children and adults the use of thrombolytic drugs appears to be a promising medical approach to thromboembolic disease. (nih.gov)
- New thrombolytic drugs have been designed to overcome these shortcomings. (semanticscholar.org)
- Through decades of basic research to identify new drugs and unravel the underlying mechanisms of action, researchers are developing newer, more powerful therapies. (faseb.org)
- A CT scan is essential in evaluating for a hemorrhagic event, which contraindicates thrombolytic therapy. (aafp.org)
- The major risk of receiving thrombolytic therapy (TPA) is hemorrhage. (merlot.org)
- Hemorrhage is the major adverse effect of thrombolytic therapy, but its incidence can be reduced by careful selection of patients and avoidance of unnecessary invasive procedures. (scripps.edu)
- The CT brain scan must ascertain the absence of hemorrhage before thrombolytic therapy is initiated. (aafp.org)
- At the acute stage of cerebral ischaemia, the only effective drug that increases the proportion of patients who survive without dependency is thrombolytic therapy by intravenous (i.v.) tissue-plasminogen activator (t-PA). (clinicaltrials.gov)
- Due to the patient's malignancy and risk of bleeding, prolonged low-dose thrombolytic therapy [25 mg tissue plasminogen activator (tPA) infusion for 6 h] was administered to the peripheral vein, according to a previous study by Aykan et al (5), rather than a standard thrombolytic regime. (nih.gov)
- Nattokinase See Tissue plasminogen activator and Maggot therapy. (wikipedia.org)