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*  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
https://openi.nlm.nih.gov/detailedresult.php?img=PMC4214487_OL-08-06-2779-g01&req=4
*  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
https://www.credihealth.com/doctors/mumbai/thrombolytic-therapy
*  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 ...
http://circ.ahajournals.org/content/113/5/e64
*  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 ...
http://square.umin.ac.jp/jscvs/eng/journal/vol39-5/262.html
*  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 patient's care. The DRG system is in place to incentivize ...
http://stroke.ahajournals.org/content/43/4/1131.long
*  Intravenous Thrombolytic Therapy in Acute Ischemic Stroke: The Experience of K tahya [Turk J Neurol]
Results: Of the patients 23 were male and 29 were female. The mean age was 70,7 12,8 (41-92). Intracranial hemorrhage after treatment was observed in 8 patients (15,4%). Of these, 6 patients (11,5%) had asymptomatic hemorrhage, 2 patients (3,8%) had symptomatic hemorrhage. The mean score of mRS was in sixteen patients (30,8%) 0-1, 10 patients (19,2%) 2-3 and 13 patients (25%) 4-5. The mean mRS score of seven patients with TACI ( 20%) was 0-1. The mean mRS score of eight patients with PAC (57,1%) was 0-1. Thirteen patients (25%) died within 3 months after the treatment ...
http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-35651&look4=
*  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.. ...
http://eprints.kingston.ac.uk/35141/
*  Efficiency of Intravenous Thrombolytic Therapy in Isolated Middle Cerebral Artery Occlusions: A CT Angiography Study [Turk J...
Materials and Methods: Data of patients with treated with IV rt-PA within 4,5 hours of symptom onset were analyzed from March 2015 to January 2017, retrospectively. Patients were divided into two groups; those with isolated MCA occlusion and those without any large vessel occlusion. Large vessel occlusion was detected with contrast-enhanced CT angiography (CTA) performed before IV rt-PA. Additionally, demographic and clinical data of the patients were analyzed. Clinical outcomes of the patients were determined by the modified Rankin Scale (mRS) score at 3 months after treatment ...
http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-23921
*  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 ...
http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-23921&look4=
*  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, people's awareness of diseases and an outstanding stroke team are both essential. ...
http://enoffical.shh.org.tw/enUI/C/C10200.aspx
*  Effect of Thrombolytic Therapy on the Evolution of Baroreceptor Sensitivity After Myocardial Infarction | Clinical Science
Thank you for your interest in spreading the word about Clinical Science.. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.. ...
http://www.clinsci.org/content/83/s27/11P.2
*  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:. ...
http://annals.org/aim/article-abstract/2540281/rescue-angioplasty-reduced-cardiovascular-cerebrovascular-outcomes-acute-mi-after-failed
*  Morphological Characteristics of Culprit Atheromatic Plaque Are Associated With Coronary Flow After Thrombolytic Therapy | JACC...
The main findings of the present study indicate that lesions of patients with STEMI and TIMI flow grade 3 after thrombolysis have greater minimal FCT, reduced incidence of plaque rupture, and less lipid quadrants. In this study, the association of specific morphologic plaque characteristics with the outcome of thrombolysis is reported.. Although thrombolysis reduces mortality, only about half of the patients achieve normal flow after thrombolysis (1). Several predictors of coronary blood flow following thrombolytic administration have been suggested (3,4). However, the impact of morphological characteristics of the culprit lesion on blood flow restoration has not been studied, possibly due to the lack of high-resolution imaging methods. Lately, the use of OCT allows accurate fibrous cap measurement due to its excellent spatial resolution, although the limited penetration of OCT permits partial plaque component characterization (9,10,17,18,20,21).. The increased concentration of tissue factor ...
http://www.interventions.onlinejacc.org/content/3/5/507
*  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
https://link.springer.com/article/10.1023%2FA%3A1022041019511
*  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, ...
http://stroke.ahajournals.org/content/40/8/2875
*  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 ...
http://heart.bmj.com/content/67/2/122
*  Download Thrombolytic Therapy in Acute Ischemic Stroke III - Takenori Yamaguchi, Etsuro Mori, Kazuo Minematsu pdf
On the threshold of an exciting new era for acute stroke diagnosis and treatment, the Third International Symposium on Thrombolytic Therapy in Acute Ischemic
http://medical-ebooks.net/31546-download-thrombolytic-therapy-in-acute-ischemic-stroke-iii-pdf/
*  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. ...
http://www.aafp.org/afp/2000/0115/p485.html
*  Identifying failure to achieve complete (TIMI 3) reperfusion following thrombolytic treatment: how to do it, when to do it, and...
The nihilist's view might be that there is no convincing evidence to support the use of either rescue thrombolysis or rescue PTCA in patients with failed reperfusion, and so why bother to try to identify it.. The "RESCUE" trial is the largest randomised trial of rescue PTCA, and recruited 151 patients with TIMI 0/1 flow in the infarct related artery , 8 hours from the onset of chest pain. It showed a trend towards lower mortality and less heart failure which almost reached significance.11 This trial did not recruit patients with TIMI 2 flow and it was conducted in the pre-stent/IIb/IIIa blocker era. Subgroup analysis in TIMI 4 and TAMI clearly confirmed that rescue PTCA could convert the majority of patients with , TIMI 3 flow to TIMI 3 even without the use of stents and IIb/IIIa blockers, but there was a high reocclusion rate and a very high mortality in patients with failed rescue PTCA.12 13 In a more contemporary population of patients undergoing rescue PTCA reported in this issue ofHeart, ...
http://heart.bmj.com/content/84/2/113
*  Thrombolytic Therapy
Glossary of Terms Thrombolytic Therapy The use of medication that has the ability to dissolve blood clots in a vein or artery. ...
http://www.surgery.usc.edu/cvti/z-glossary-thrombolytictherapy.html
*  Ten-Year Follow-Up of the First Megatrial Testing Thrombolytic Therapy in Patients With Acute Myocardial Infarction |...
Given the relative absence of criteria limiting enrollment, the GISSI-1 experimental population can be assumed to be a reliable epidemiological reference population. Accordingly, a concise reflection on the long-term survival of the population that opened the thrombolytic era appears appropriate for reviewing some of the points that have remained open to debate during the subsequent 10-year period.16 17 First, our results demonstrate that the benefits of a single intravenous infusion of 1.5 million units of SK in prolonging survival of patients with an acute MI is sustained up to 10 years after randomization. The 10-year follow-up of a relatively simple and inexpensive intervention reproduces an astonishing coherence of the original findings. Follow-up reports published so far, including the first one from GISSI-1,3 have consistently supported the maintenance of the short-term benefit, with no evidence either of convergence or divergence of survival curves.18 19 20 So far, longer-term ...
http://circ.ahajournals.org/content/98/24/2659
*  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
http://slideplayer.com/slide/3883321/
*  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 ...
https://clinicaltrials.gov/ct2/show/record/NCT00338585
*  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 ...
https://clinicaltrials.gov/show/NCT00000550
*  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 ...
http://www.strokecenter.org/trials/clinicalstudies/the-norwegian-sonothrombolysis-in-acute-stroke-study/description