- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Warning of severe pulmonary embolism after cerebral angiography: A case report and literature review. (Pubmed Central) - Sep 27, 2024
PE is a rare complication of cerebral angiography, but the fatality rate is very high. Neurologists must not only early identify and effectively treat this complication, but more importantly, pay attention to this complication, prevent it in advance, and reduce the occurrence of catastrophic events.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal, HEOR, Cost-effectiveness, Cost effectiveness: Endovascular Thrombectomy Alone for Large Vessel Occlusion: A Cost-Effectiveness Evaluation Based on Meta-Analyses. (Pubmed Central) - Sep 24, 2024
Intravenous alteplase before EVT was not cost-effective in patients with large vessel occlusion in the Netherlands at the $52?500 threshold but possibly cost-effective at the $84?000 threshold. Variable functional outcomes at 3 months based on different trial populations affected the cost-effectiveness of intravenous alteplase before EVT.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Mortality Outcomes with Tenecteplase Versus Alteplase in the Treatment of Massive Pulmonary Embolism. (Pubmed Central) - Sep 21, 2024
The results necessitate prospective evaluation. Given the cost-effectiveness and ease of administration of TNK, these findings contribute to the ongoing discussion about its adoption as a primary thrombolytic agent for stroke and PE.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Emergency Department and Critical Care Use of Clevidipine for Treatment of Hypertension in Patients with Acute Stroke. (Pubmed Central) - Sep 20, 2024
We conclude that the salutary findings of the initial small study are valid across a larger patient sample of all acute stroke types. Based on these data, clevidipine is shown to be safe, consistent, and effective in the treatment of acute hypertension in ischemic and hemorrhagic stroke events, and is a reasonable first-line treatment option for acute hypertension in this setting.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
CAUGHT IN TRANSIT: MOBILE RIGHT ATRIAL THROMBUS IN TRANSIT TO LEFT ATRIUM THROUGH PERCUTANEOUS FORAMEN OVALE (Convention Center Exhibit Hall: Rapid Fire Area 1B) - Sep 11, 2024 - Abstract #CHEST2024CHEST_6479;
Patient was placed on non-invasive ventilation and started on a nitroglycerin drip...Alteplase was not used due to concerns of clot fragmentation...Patient was subsequently discharged with home health on apixaban... In management of life-threatening CIT with PE, percutaneous intervention may be more favorable in patients with multiple comorbidities who cannot tolerate mechanical thrombectomy or systemic anticoagulation.
- |||||||||| Rituxan (rituximab) / Roche, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
MICROSCOPIC POLYANGIITIS; A RARE PRESENTATION WITH CARDIAC TAMPONADE AND A COMPLEX PLEURAL EFFUSION (Convention Center Exhibit Hall: Poster Area 3) - Sep 11, 2024 - Abstract #CHEST2024CHEST_6440;
Clinicians should be vigilant regarding rare initial presentations of vasculitis especially in the setting of multiorgan involvement. Specific findings of pericarditis or cardiac tamponade with pleural effusions with AKI without resolution should raise a question of vasculitis and should be ruled out in order promptly to start immunosuppressive therapy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SEALING THE LEAK: ENDOBRONCHIAL VALVE PLACEMENT IN EXTENSIVE ALVEOPLEURAL FISTULA FOLLOWING PNEUMONIA (Convention Center Exhibit Hall: Rapid Fire Area 2C) - Sep 11, 2024 - Abstract #CHEST2024CHEST_6307;
Hence despite chest tube placement and administration of adequate antibiotics, air leak persisted. Skillful placement of EBVs provided an effective one-way seal, resulting in the resolution of the associated pneumothorax and allowing the removal of chest tubes.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
INTRAPLEURAL TPA/DNASE FOR PLEURAL INFECTIONS: A SINGAPORE TERTIARY CENTER'S EXPERIENCE (Convention Center Exhibit Hall: Rapid Fire Area 1B) - Sep 11, 2024 - Abstract #CHEST2024CHEST_6297;
The majority were unfit for surgery and in these patients, IPFT was a safe alternative with a low incidence of bleeding. Our overall rates of survival to hospital discharge with avoidance of surgery (85.5%) is comparable to prior studies, despite a trend towards lower doses of intrapleural alteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Advancing the management of acute intermediate-high-risk pulmonary embolism: The enduring legacy of Professor Guy Meyer. (Pubmed Central) - Sep 8, 2024
In 1992, Guy Meyer demonstrated the fast improvement of pulmonary haemodynamics after alteplase administration; this drug has remained the mainstay of thrombolysis for PE over almost 35 years...Increasingly, focus is being placed on long-term functional and patient-reported outcomes, including quality of life indicators, as well as on the utilization of health care resources. The pioneering work of Guy Meyer will thus continue to have a major impact on the management of PE for years to come.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Journal: Adjunctive Intravenous Argatroban or Eptifibatide for Ischemic Stroke. (Pubmed Central) - Sep 4, 2024
P3
In patients with acute ischemic stroke treated with intravenous thrombolysis within 3 hours after symptom onset, adjunctive treatment with intravenous argatroban or eptifibatide did not reduce poststroke disability and was associated with increased mortality. (Funded by the National Institute of Neurological Disorders and Stroke; MOST ClinicalTrials.gov number, NCT03735979.).
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: A low bleeding risk thrombolytic agent: citPA5. (Pubmed Central) - Sep 2, 2024
As a result, citPA5 shows great potential for administration prior to the classification of stroke types, making it possible for use in ambulances at the onset of stroke when symptoms are identified. The findings presented in this study also suggest that this strategy could be applied to develop a new generation of fibrinolytic drugs that offer greater safety and specificity in targeting fibrin.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
Journal: Tenecteplase Catheter-Directed Thrombolytic Therapy in Submassive Pulmonary Embolism: A Case Report. (Pubmed Central) - Sep 1, 2024
Introduction: In pulmonary embolism (PE), when used for catheter-directed thrombolysis (CDT), low-dose alteplase is associated with good outcomes...The patient regained his baseline physical and mental functions and was discharged on enoxaparin and amiodarone tablet...The combination to therapeutic heparin infusion, already described in different clinical scenarios with intravenous tenecteplase, was safe and well tolerated CDT with tenecteplase was, for the first time, safely and effectively used in an intermediate high-risk PE patient. However, more studies are needed to confirm and establish these findings.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Haemorrhage after thrombectomy with adjuvant thrombolysis in unknown onset stroke depends on high early lesion water uptake. (Pubmed Central) - Aug 27, 2024
In patients with ischaemic stroke with unknown onset, the combination of high NWU with IVT is directly linked to higher rates of sICH. Besides ASPECTS for evaluating the extent of the early infarct lesion, quantitative NWU could be used as an imaging biomarker to assess the degree of blood-brain barrier damage in order to predict the risk of sICH in patients with wake up stroke.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
P3 data, Retrospective data, Journal: Tenecteplase versus alteplase for acute ischaemic stroke: a meta-analysis of phase III randomised trials. (Pubmed Central) - Aug 27, 2024
TNK was non-inferior to alteplase for achieving excellent functional outcome at 90 days without increasing the safety concern in treating patients with AIS. These findings suggest that TNK can be an alternative to alteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Mechanisms of mitophagy and oxidative stress in cerebral ischemia-reperfusion, vascular dementia, and Alzheimer's disease. (Pubmed Central) - Aug 22, 2024
Despite the availability of the U.S. Food and Drug Administration (FDA)-approved clinical first-line drugs for AD, including memantine, donepezil hydrochloride, and galantamine, these agents do not fundamentally block the pathological process of AD. In this paper, we undertake a review of the mechanisms of mitophagy and oxidative stress in neurological disorders, a summary of the clinical trials conducted in recent years, and a proposal for a new strategy for targeted treatment of neurological disorders based on both mitophagy and oxidative stress.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Successful Thrombolysis of an Obstructive Prosthetic Mitral Valve Thrombosis Using Alteplase. (Pubmed Central) - Aug 20, 2024
Subsequent TTE revealed a mean gradient of 5 mm Hg, and cine fluoroscopy showed improved mitral valve motion, thereby indicating successful thrombolysis. The patient felt symptomatically relieved within 6 hours and is presently on OAC therapy with strict drug compliance.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
Journal: Angioedema Secondary to Tenecteplase Use in a Patient with Acute Ischemic Stroke: A Case Report. (Pubmed Central) - Aug 19, 2024
Risk factors for alteplase-associated angioedema include use of angiotensin-converting enzyme inhibitors, female gender, diabetes, and infarcts of the insula and frontal cortex. As hospital systems switch from alteplase to tenecteplase for the treatment of acute ischemic strokes for reasons of cost and ease of administration, it is important to recognize that angioedema is also a potential complication of tenecteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: A potential prospect: The novel treatment of intrapleural saline irrigation with intrapleural tyloxapol in treating thoracic empyema. (Pubmed Central) - Aug 12, 2024
The treatment for empyema thoracis has been evolving over the years, including the usage of intrapleural fibrinolytic therapy (IPFT), for example, alteplase with intrapleural deoxyribonuclease (DNase) to enhance the drainage of pleural effusion...Upon follow-up, both cases showed clinical cure, biochemical recovery, and radiological improvement, indicating a good treatment outcome. This is the first reported cases on combination of saline irrigation with tyloxapol as alternative treatment for pleural infection.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Successful pharmaco-invasive approach using a lower alteplase dose and VA-ECMO support in high-risk pulmonary embolism: case report. (Pubmed Central) - Aug 6, 2024
Here, we present the case of a 61-year-old male with high-risk PE associated with refractory cardiac arrest and cardiogenic shock who underwent a combination of extracorporeal cardiopulmonary resuscitation with VA-ECMO and pharmaco-invasive therapy (mechanical thrombi fragmentation plus lower alteplase dose), resulting in successful pulmonary reperfusion. After a prolonged in-hospital stay, the patient was discharged in stable condition.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Hyperacute ischemic stroke care-Current treatment and future directions. (Pubmed Central) - Aug 4, 2024
Therefore, deciding who not to treat with thrombectomy is a key clinical challenge that requires careful but rapid integration of clinical, imaging, and patient preference considerations. Systems of care to accelerate delivery of these highly effective therapies will maximize benefits for the greatest number of patients with stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Aetiology and management of persistent withdrawal occlusion in venous ports in oncology patients. (Pubmed Central) - Aug 3, 2024
Mechanical disruption (MD) with a syringe of saline using the flush method was used; in case of its failure, subsequent administration of a lock solution with taurolidine and urokinase, or low-dose thrombolysis with alteplase was indicated...We created a method for resolving PWO using MD +/- application of thrombolytics with 97.4% success rate. Current evidence showed that FS is not likely to be affected by thrombolytic drugs; however, we have ascertained an effect of these drugs, proposing a hypothesis of microthrombotic events at the tip of the catheter if fibroblastic sleeve is present.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
ACUTE ONSET OF RIGHT LEG PARALYSIS: AN UNUSUAL PRESENTATION OF TYPE A AORTIC DISSECTION (Convention Center 257 AB) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4977;
Approximately 30 minutes after initial presentation, the patient had onset of severe crescendo right limb pain treated with 8 mg of IV morphine... Atypical presentations of aortic dissection should be considered with sudden onset of lower extremity paralysis and paresthesia in at risk patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
UNCOMMON CAUSE OF HOMOCYSTEINEMIA CONTRIBUTING TO HYPERCOAGULABLE STATE IN PULMONARY EMBOLISM (Convention Center Exhibit Hall: Rapid Fire Area 4D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4874;
Nitrous oxide abuse can cause life-threatening thromboembolic events through homocysteinemia. Any history of recreational exposure should be actively elicited to identify and diagnose potentially reversable triggers of thromboembolism.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
CHYLOTHORAX SECONDARY TO TUNNELED-CATHETER-INDUCED SUPERIOR VENA CAVA OBSTRUCTION (Convention Center 258 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4107;
SVC obstruction should be considered among patients with thoracic intravascular devices and chylothorax. Thoracic venous angiogram can identify the obstruction site and allow therapeutic interventions.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
ACUTE INTERMEDIATE-RISK PULMONARY EMBOLISM WITH REFRACTORY HYPOXEMIA IN THE SETTING OF PREVIOUSLY UNDIAGNOSED PATENT FORAMEN OVALE: A CASE SERIES (Convention Center 257 AB) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4051;
Refractory hypoxemia in the setting of intermediate-risk PE should raise suspicion for acute right-to-left intracardiac shunt masking the hemodynamic impact and extent of true clot burden. Clinicians should consider the possibility and effects of shunt physiology when risk stratifying these patients, including risk for further decompensation, and when considering earlier and/or more aggressive interventions.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
ADVANCED THERAPIES FOR ACUTE PE: AN INQUIRY OF US VETERANS AFFAIRS MEDICAL CENTERS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3761;
Potential barriers to IHT are bed availability and nursing shortages. Academic centers with PCCM programs utilized their PCCM fellows/staff and the university hospital for decision support and IHT.
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