Articles Tagged With: Thrombolysis
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban for Ischemic Stroke
Glycoprotein IIb/IIIa receptor inhibitors are potent, rapidly acting antiplatelet agents that have been tried in pilot studies to treat acute ischemic stroke, without significant benefit. Tirofiban is fast-acting, highly selective, and has a short half-life that allows bleeding time to return to normal within three hours after administration is stopped. The investigators proposed that this medication may be of benefit in patients with acute ischemic stroke who arrived within 24 hours after stroke onset but are not eligible for thrombolysis or thrombectomy or have progression of stroke symptoms after receiving thrombolysis.
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Thrombolysis vs. Surgery for Thrombosed Mechanical Prosthetic Valves
A study of patients with obstructive prosthetic valve thrombosis that deployed low-dose, slow infusion thrombolysis or surgery using shared decision-making, showed thrombolysis was highly effective and resulted in fewer major complications than surgery.
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Mobile Stroke Units: What Is the Best Way to Use Them?
A recent advance in ischemic stroke treatment is the mobile stroke unit, an ambulance outfitted with specialized equipment, computed tomography for brain imaging, and a specialized team with a stroke neurologist available either onboard or via telemedicine. Intravenous thrombolytics can be administered at the scene with the patient on the ambulance.
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Intravenous Thrombolysis Prior to Mechanical Thrombectomy Improves Outcome
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Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke
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Thrombolysis for ‘Wake-up’ Stroke
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Functional Outcomes in Acute Ischemic Stroke Patients Receiving Prehospital Thrombolysis in Mobile Stroke Units
Deployment of a mobile stroke treatment unit in the field results in a higher percentage of patients treated with intravenous tPA, at a shorter interval from onset of symptoms, and results in better outcomes.
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Cerebral Microbleeds Are Risk Factor for Symptomatic Intracerebral Hemorrhage in Patients Undergoing IV Thrombolysis
Cerebral microbleeds, as visualized on gradient-echo or susceptibility-weighted MRI, are considered markers of bleeding-prone cerebral microvessels and constitute a significant and independent predictor of future intracerebral hemorrhage.
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Acute Ischemic Stroke: Focus on Reperfusion
Time is brain. Neural tissue’s exquisite sensitivity to ischemia indicates the emergency nature of acute stroke care. The faster that definitive stroke treatment is administered following the onset of ischemia, the better the outcomes.