DiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesInformation ScienceNamed GroupsHealth Care
Thrombolytic TherapyFibrinolytic AgentsTissue Plasminogen ActivatorStreptokinaseMyocardial InfarctionStrokePlasminogen ActivatorsAnistreplaseUrokinase-Type Plasminogen ActivatorPulmonary EmbolismBrain IschemiaTreatment OutcomeHeparinCerebral HemorrhageMyocardial ReperfusionTime FactorsEmbolectomyThrombosisAcute DiseaseCoronary Care UnitsFibrinolysisHeart Rupture, Post-InfarctionIntracranial ThrombosisHemorrhageElectrocardiographyIntracranial HemorrhagesAngioplasty, Balloon, CoronaryFibrinolysinCarotid Artery ThrombosisInfusions, IntravenousProspective StudiesCoronary ThrombosisCoronary AngiographyEmergency Medical ServicesRecurrenceIntracranial Embolism and ThrombosisInjections, IntravenousRecombinant ProteinsVascular PatencyEmergenciesInfusions, Intra-ArterialTomography, X-Ray ComputedIntracranial EmbolismVenous ThrombosisCerebral InfarctionHirudin TherapyEmergency TreatmentAnticoagulantsCreatine KinaseEmergency Medical TechniciansRadionuclide VentriculographyRetrospective StudiesHospital MortalityInjections, Intra-ArterialThrombectomyReperfusionFibrinopeptide ACerebral AngiographyFollow-Up Studies
Ischemic strokeThrombolysisReperfusion therapyFibrinolytic therapyAcute StrokeIschaemic strokeTrials regarding thStreptokinaseEndovascular therapyTirofibanOnsetPlasminogenPatientsOutcomeClotTreatmentElevation myocardialAngioplastyMechanicalMedicationOutcomesAnticoagulant therapyMortalityHeparinAdministrationTimeInterventionArteryClinicalContraindicationsTrialRiskResultsApply
Ischemic stroke17
  • 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)
  • The use of intravenous tPA within 3 hours after acute ischemic stroke has been proved to increase the number of good outcomes. (umn.edu)
  • Koller, RL & Anderson, DC 1998, ' Intravenous thrombolytic therapy for acute ischemic stroke: Weighing the risks and benefits of tissue plasminogen activator ', Postgraduate medicine , vol. 103, no. 4, pp. 221-231. (umn.edu)
  • Anderson, David C. / Intravenous thrombolytic therapy for acute ischemic stroke : Weighing the risks and benefits of tissue plasminogen activator . (umn.edu)
  • Based on the results of these studies, the Food and Drug Administration (FDA) approved the use of intravenous alteplase for the treatment of acute ischemic stroke when given within 3 hours of stroke symptom onset. (jointcommission.org)
  • Intravenous thrombolysis (IVT) is a standard procedure for the treatment of patients with acute ischemic stroke (AIS). (frontiersin.org)
  • Adults with acute ischemic stroke and elevated BP who are eligible for treatment with intravenous tissue plasminogen activator should have their BP slowly lowered to less than 185/110 mm Hg before thrombolytic therapy is initiated. (medscape.com)
  • In adults with an acute ischemic stroke, BP should be less than 185/110 mm Hg before administration of intravenous tissue plasminogen activator and should be maintained below 180/105 mm Hg for at least the first 24 hours after initiating drug therapy. (medscape.com)
  • METHODS: This multicenter cohort study included 2373 patients with acute ischemic stroke treated with intravenous thrombolysis between December 2004 and December 2016. (tmu.edu.tw)
  • CONCLUSIONS: This study supports the strong association between reduced LDL-C and increased SICH, but not for functional outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. (tmu.edu.tw)
  • Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) Study Group 2019, ' Low Cholesterol Levels Increase Symptomatic Intracranial Hemorrhage Rates After Intravenous Thrombolysis: A Multicenter Cohort Validation Study ', Journal of Atherosclerosis and Thrombosis , 卷 26, 編號 6, 頁 513-527. (tmu.edu.tw)
  • Systemic thrombolysis with recombinant tissue plasminogen activator is the "gold standard" of reperfusion therapy, having the maximum level of evidence in European and North American guidelines for the treatment of patients with acute ischemic stroke (IS). (annaly-nevrologii.com)
  • This study aimed to assess the 3-month outcome of patients who underwent thrombolytic therapy following ischemic stroke. (ac.ir)
  • In the present prospective cohort study, the 3-month outcome of patients (mortality, disability) with acute ischemic stroke admitted to neurology department an educational hospital, Kermanshah, Iran, from 2016 to 2019, who had received thrombolytic therapy was assessed. (ac.ir)
  • Currently, systematic intravenous alteplase administered within 4.5hrs after symptom onset is the mainstay of therapy, however many question its risk/benefit ratio in ischemic stroke. (rebelem.com)
  • There have been many studies evaluating endovascular therapy in the management of ischemic stroke published in the past few years. (rebelem.com)
Thrombolysis19
  • Catheter-directed thrombolysis involves the acceleration of the body's natural thrombolytic pathway. (medscape.com)
  • Heparin therapy and oral anticoagulant therapy must always follow a course of thrombolysis. (medscape.com)
  • Thrombolysis, also called fibrinolytic therapy, is the breakdown (lysis) of blood clots formed in blood vessels, using medication. (wikipedia.org)
  • Thrombolysis can also play an important part in reperfusion therapy that deals specifically with blocked arteries. (wikipedia.org)
  • For the treatment of a massive pulmonary embolism, catheter-directed therapy is a safer and more effective alternative to systemic thrombolysis. (wikipedia.org)
  • Severe deep vein thrombosis (DVT), such as phlegmasia cerulea dolens, which threatens limb loss, or iliofemoral DVT, where clots involve at a minimum the common iliac vein Acute limb ischaemia Clotted hemothorax Thrombolysis is usually intravenous. (wikipedia.org)
  • ICA occlusion of intravenous thrombolysis trials in patients with acute stroke have been based on the CT exclusion of hemorrhage 9 and on CT parenchymal evaluation 10 , 11 but have not pursued the exact cause or the level of occlusion. (ajnr.org)
  • Intravenous thrombolysis or/and intraarterial thrombectomy to reopen occluded cerebral arteries is a standard treatment procedure for AIS patients. (frontiersin.org)
  • In smaller hospitals, especially in rural areas, intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the mainstay for AIS patients ( 3 , 4 ). (frontiersin.org)
  • Further studies on how to improve the therapeutic efficacy of intravenous thrombolysis are always important. (frontiersin.org)
  • Early neurological deterioration (END) within the first 24 h after intravenous thrombolysis is a major problem leading to poor outcomes in AIS patients ( 5 ). (frontiersin.org)
  • Thrombolysis medication errors: benefits of bolus thrombolytic agents. (tci-thaijo.org)
  • Thrombolysis is usually intravenous . (wikimili.com)
  • Fibrin-bound plasminogen will be converted by thrombolytic drugs to plasmin, the rate-limiting step in thrombolysis. (medscape.com)
  • The goal of the Acute Stroke Team is to rapidly evaluate and treat acute stroke patients, including a door-to-needle time of less than one hour for patients who are eligible for intravenous thrombolysis and identify candidates for mechanical thrombectomy who present within 24 hours of last known well, regardless of whether they receive intravenous thrombolytic therapy for the same ischemic stroke event. (ucdavis.edu)
  • Intravenous thrombolysis within a three-hour window of last known well. (ucdavis.edu)
  • Intravenous thrombolysis outside a three-hour window for eligible patients based on the most recent guidelines and qualified studies. (ucdavis.edu)
  • During the current SARS-CoV-2 pandemic the restructure of healthcare services to meet the huge increase in demand for hospital resource and capacity has led to the proposal that where necessary ST elevation myocardial infarction (STEMI) could be managed by intravenous thrombolysis in the first instance as a means of reducing the workforce requirements of a primary angioplasty service run at a heart attack centre. (rcpjournals.org)
  • Current discussions, and indeed recommendations in some countries, have proposed that intravenous thrombolysis could be employed instead of PPCI as the initial management for STEMI in the event of insufficient staff numbers, either due to redeployment or illness. (rcpjournals.org)
Reperfusion therapy6
Fibrinolytic therapy8
  • The way these drugs work is also referred to as fibrinolytic therapy. (healthline.com)
  • Stated simply, this is performance of a PCI in a closed artery following fibrinolytic therapy. (wikidoc.org)
  • Stated simply, this is performance of a PCI in an open artery following fibrinolytic therapy. (wikidoc.org)
  • Thrombin activity is increased in patients with acute myocardial infarction was found to increase more after the receiving of fibrinolytic therapy. (researchsquare.com)
  • Incidence and predictors of bleeding events after fibrinolytic therapy with fibrin-specific agents: a comparison of TNK-tPA and rt-PA. (tci-thaijo.org)
  • Andersen HR, Nielsen TT, Rasmussen K. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction N Engl J Med. (sagepub.com)
  • A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. (jamanetwork.com)
  • In a meta-analysis of 23 randomized trials comparing PCI with fibrinolytic therapy, there was a significantly lower risk of short-term death, stroke, or nonfatal MI in those who received PCI. (uscjournal.com)
Acute Stroke1
Ischaemic stroke2
  • Computed tomography (CT) must be done before thrombolytic treatment of hyperacute ischaemic stroke, but the significance of early ischaemic change on CT is unclear. (nih.gov)
  • 203 consecutive patients with ischaemic stroke were treated with intravenous alteplase within 3 h of symptom onset in two North American teaching hospitals. (nih.gov)
Trials regarding th1
  • The decision whether to use percutaneous transcatheter treatment and, if so, which technique to choose, is complicated by the lack of data from multicenter prospective randomized trials regarding the safety and efficacy of these therapies. (medscape.com)
Streptokinase3
Endovascular therapy4
  • The goals of endovascular therapy include reducing the severity and duration of lower-extremity symptoms, preventing PE, diminishing the risk of recurrent venous thrombosis, and preventing postthrombotic syndrome (PTS). (medscape.com)
  • Introduction Perfusion imaging according to the DEFUSE 3 or DAWN criteria has been applied to select patients with large vascular occlusive stroke undergo endovascular therapy (EVT) in the extended time window. (bmj.com)
  • Endovascular therapy (EVT) has become a standard care for patients with large vessel occlusive stroke within 6 hours. (bmj.com)
  • however, endovascular therapy can only be performed in selected high-performing stroke centers. (frontiersin.org)
Tirofiban2
  • Of these, 14 patients were treated with regular antiplatelet agents (aspirin plus clopidogrel) and 59 patients were treated with tirofiban within 24 h of IVT, followed by regular antiplatelet therapy. (frontiersin.org)
  • I was 4.7 ng/mL (upper limit 0.01 ng/ and intravenous tirofiban was added to The incidence of systemic emboliza- mL) and INR was 1.6. (who.int)
Onset3
  • Although the onset of WUS is unknown, a few studies investigated the potential benefit ofmagnetic resonance imaging (MRI) in estimating the age of onset which encouraged conductingclinical trials assessing the efficacy of MRI-guided thrombolytic therapy in WUS. (civilica.com)
  • Symptomatic ICH (SICH) rates within 24-36 h of thrombolytic onset and functional outcomes at 30 and 90 days were longitudinally surveyed. (tmu.edu.tw)
  • The importance of study is to use diffusion weighted/Fluid attenuated inversion recovery (DWI/FLAIR) mismatch as a radiological marker which can help to identify patients with lacunar and non-lacunar stroke within 4.5 hours of onset and use it to determine whether patients with unknown onset stroke qualify for thrombolytic therapy or not. (bvsalud.org)
Plasminogen4
Patients8
  • We did a search of published work and identified 23 trials, which together randomly assigned 7739 thrombolytic-eligible patients with ST-segment elevation AMI to primary PTCA (n=3872) or thrombolytic therapy (n=3867). (nih.gov)
  • Most patients who received thrombolytic therapy (76%, n=2939) received a fibrin-specific agent. (nih.gov)
  • 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)
  • This CT score is simple and reliable and identifies stroke patients unlikely to make an independent recovery despite thrombolytic treatment. (nih.gov)
  • Traditionally, a typical phase II trial has been conducted using a single-arm design recruiting patients only to the experimental therapy to be compared with a historical control. (annexpublishers.com)
  • Ten-year follow-up of the first megatrial testing thrombolytic therapy in patients with acute myocardial infarction:results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto-1 study. (tci-thaijo.org)
  • There was no significant correlation between 3-month disabilities of stroke patients underwent thrombolytic therapy and age, sex, time from initiation of symptoms, or vital signs on admission. (ac.ir)
  • Patients receive early attention by speech therapy, occupational therapy, and physical therapy to initiate rehabilitation activities. (ucdavis.edu)
Outcome2
Clot2
  • If you have a blood clot blocking an artery, your doctor may inject medication through an intravenous line or a catheter to dissolve the clot. (mountelizabeth.com.sg)
  • The history of thrombolytic therapy began in 1933, when it was discovered that filtrates of broth cultures of certain streptococcal strains (beta-hemolytic streptococci) could dissolve a fibrin clot. (medscape.com)
Treatment2
Elevation myocardial1
Angioplasty1
  • thrombolytic agents, angioplasty and valves. (who.int)
Mechanical1
  • Modern VTE prophylaxis, which consists of pharmacologic therapy or mechanical compression devices, can reduce the incidence of symptomatic VTE to approximately 0.5%–1% during the hospitalization. (cdc.gov)
Medication1
  • Direct intrathrombus injection of the thrombolytic agent protects the medication from deactivation by circulating inhibitors and achieves higher drug concentration at the site of thrombosis with a lower total dose than would be used for systemic intravenous thrombolytic therapy. (medscape.com)
Outcomes1
  • We identified short-term and long-term clinical outcomes of death, non-fatal reinfarction, and stroke, and did subgroup analyses to assess the effect of type of thrombolytic agent used and the strategy of emergent hospital transfer for primary PTCA. (nih.gov)
Anticoagulant therapy2
  • When an invasive procedure is considered, the benefit must be weighed against the added risk compared with standard anticoagulant therapy. (medscape.com)
  • Thrombolytic therapy offers significant advantages over conventional anticoagulant therapy, including the prompt resolution of symptoms, the prevention of pulmonary embolism, the restoration of normal venous circulation, the preservation of venous valvular function, and the prevention of postthrombotic syndrome. (medscape.com)
Mortality1
Heparin1
  • Acetylsalicylic acid, thought to be due to coronary embo- in recent years, systemic thromboem- beta-blockers and intravenous heparin lism. (who.int)
Administration1
  • In such cases, a pharmaco-invasive strategy by the administration of lytic therapy is followed by immediate transfer to (PPCI) capable center for either rescue percutaneous coronary intervention (PCI), in case of failed fibrinolysis, or routine coronary angiography and PCI. (researchsquare.com)
Time3
Intervention2
  • Critical decisions focus on the need for intubation, blood pressure control, and determination of risk/benefit for thrombolytic intervention. (medscape.com)
  • If it is to be performed, the intervention must improve the results of current medical therapy. (medscape.com)
Artery1
Clinical2
  • 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)
  • HTA groups such as NICE and ANAES (Agence Nationale d'Accreditation et d'Evaluation en Sante) in France are seen as being much more influential since they impact on clinical practice and reimbursement. (bmj.com)
Contraindications1
  • Recent recommendations from the American Heart Association/American Stroke Association and FDA remove or make less specific many previous contraindications and warnings for therapy. (jointcommission.org)
Trial1
Risk2
  • However, tPA is a toxic therapy that carries a substantial risk of intracerebral hemorrhage. (umn.edu)
  • Adults with an elevated BP or stage 1 hypertension who have an estimated 10-year ASCVD risk less than 10% should be managed with nonpharmacological therapy and have a repeat BP evaluation within 3 to 6 months. (medscape.com)
Results2
  • The results seen with primary PTCA remained better than those seen with thrombolytic therapy during long-term follow-up, and were independent of both the type of thrombolytic agent used, and whether or not the patient was transferred for primary PTCA. (nih.gov)
  • that may be the cause of failure to achieve initial reperfusion or early reocclusion after initially successful results of lytic therapy. (researchsquare.com)
Apply1
  • If extravasation occurs, terminate the infusion at that site and apply local therapy. (pdr.net)