- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Rt-PA thrombolytic therapy in patients with acute posterior circulation stroke: A retrospective study. (Pubmed Central) - Jan 27, 2023
The patients treated with intravenous alteplase thrombolysis within 3 h following stroke onset benefited more than those treated with thrombolysis therapy within 3 to 4.5 h after stroke onset. On the whole, the present study demonstrates that the patients with mild stroke (NIHSS score ≤3 points) who were treated at an earlier stage (received alteplase thrombolysis therapy within 3 h after stroke onset) benefited to a greater extent from the therapy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: PLATyPuS: Inhaled Tissue Plasminogen Activator for Acute Plastic Bronchitis (clinicaltrials.gov) - Jan 27, 2023
P2, N=13, Recruiting,
On the whole, the present study demonstrates that the patients with mild stroke (NIHSS score ≤3 points) who were treated at an earlier stage (received alteplase thrombolysis therapy within 3 h after stroke onset) benefited to a greater extent from the therapy. Trial completion date: Jan 2023 --> Jun 2023 | Trial primary completion date: Dec 2022 --> Jun 2023
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SUGAR-COATING ANGIOEDEMA: RAPID REDUCTION OF TONGUE SWELLING BY TOPICAL SUCROSE APPLICATION () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1942;
Patient 3 is a 52 y-o woman with type B thoracic aortic dissection and hypertension who developed angioedema 8 hours into esmolol and nicardipine infusions...Lack of tongue protrusion from the mouth and the ability to visualize the palate may indicate that the risk of airway compromise is markedly reduced. The desiccating effect of sucrose rapidly reduced the duration or need of invasive airway management and may be an effective adjunct for angioedema.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
LOW-DOSE PERIPHERAL IV THROMBOLYTIC INFUSION FOR THE MANAGEMENT OF SUBMASSIVE PULMONARY EMBOLISM () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1923;
A retrospective analysis from June 2020 to June 2022 for submassive PE patients treated with low dose alteplase (tPA) infusion was conducted... This retrospective study demonstrates that a low dose peripheral tPA infusion was safe and provided clinical improvement rather than deterioration in a small cohort of patients with submassive PE.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
TO LYSE OR NOT TO LYSE: MANAGEMENT OF INTERMEDIATE-RISK PULMONARY EMBOLISM () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1879;
After three negative head CTs and a multidisciplinary discussion, he was treated with alteplase at a reduced dose of 50 mg (10 mg bolus, followed by 40 mg over two hours)...He was discharged on warfarin...There is not consensus currently on how to manage these patients, however, this is an important population where more data is needed. Current studies should focus on reduced dose thrombolysis and catheter directed therapies to find ways to manage patients with intermediate risk PE more safely and effectively.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
SAFETY AND EFFICACY OF TENECTEPLASE IN ACUTE ISCHEMIC STROKE () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1807;
While the reason may be due to a broader definition of sICH compared to other studies, there was still a high incidence of clinically significant bleeds that required reversal. Therefore, more evidence on the safety of TNK may be needed before selecting it as the primary treatment of choice for ischemic strokes.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
TENECTEPLASE VERSUS ALTEPLASE FOR THE TREATMENT OF ACUTE ISCHEMIC STROKE () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1481;
Therefore, more evidence on the safety of TNK may be needed before selecting it as the primary treatment of choice for ischemic strokes. Routine use of tenecteplase was found to have similar efficacy and safety to that of alteplase, and a shorter door-to-needle time.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
EVALUATION OF ALTEPLASE INFUSION DELAY FOLLOWING BOLUS AND IMPACT ON OUTCOMES IN ISCHEMIC STROKE () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1452;
Delay in alteplase infusion following bolus did not consistently show worse patient outcomes but did show an increase in 90-day mortality and mRS. Interpretation of these study results should be taken with caution due to the retrospective nature and missing data points for 90-day mRS.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
REVERSIBLE MALIGNANT CEREBRAL EDEMA FOLLOWING CRANIOPLASTY () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1418;
Description: 44-year-old female initially hospitalized in January 2021 for a right MCA occlusion; she received Alteplase and thrombectomy was performed...While obtaining the repeat CT head, the patient developed seizures with progression to status epilepticus and was started on a midazolam infusion...Our patient is the first reported survivor from this. Further research and investigation of other cases should be identified to assess for commonalities and interventions to provide the best chance of recovery.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
FUNCTIONAL RECOVERY AND THROMBUS RESOLUTION IN A YOUNG PATIENT WITH MULTIPLE STROKES () - Jan 25, 2023 - Abstract #SCCM2023SCCM_1071;
Multiple strokes are rare in young adults, nowadays the use of ultrasonography in the ICU is essential tool, provides rapid bedside diagnosis when used by adequately professionals. It is necessary to continue with the educational programs for the use of the POCUS.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
P3 data, Journal, Head-to-Head: Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation (TASTE): A multicentre, prospective, randomised, open-label, blinded endpoint, controlled phase III non-inferiority trial protocol. (Pubmed Central) - Jan 20, 2023
Trial primary completion date: Dec 2022 --> Nov 2023 This pivotal trial will provide important data on the role of tenecteplase in acute ischemic stroke, and the use of imaging-based treatment decision making for stroke thrombolysis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Safety outcomes of early initiation of antithrombotic agents within 24 h after intravenous alteplase at 0.6 mg/kg. (Pubmed Central) - Jan 20, 2023
This pivotal trial will provide important data on the role of tenecteplase in acute ischemic stroke, and the use of imaging-based treatment decision making for stroke thrombolysis. Early initiation of antithrombotics after intravenous alteplase at 0.6 mg/kg did not increase the rate of sICH or death within 3 months and may be used with caution in patients with advanced neurological deterioration.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
Trial completion, Trial completion date, Head-to-Head: TRACEⅡ: Tenecteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events-Ⅱ (clinicaltrials.gov) - Jan 17, 2023
P3, N=1430, Completed,
Early initiation of antithrombotics after intravenous alteplase at 0.6 mg/kg did not increase the rate of sICH or death within 3 months and may be used with caution in patients with advanced neurological deterioration. Recruiting --> Completed | Trial completion date: Oct 2023 --> Jul 2022
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Intravenous Thrombolytics in the Treatment of Acute Ischemic Stroke. (Pubmed Central) - Jan 10, 2023
The existing data evaluating the efficacy of TNK compared to alteplase in acute AIS within 4.5 h from symptom onset showed no significant difference between these two agents with regard to functional outcome at 90 days but improved median time to treatment and large vessel recanalization in TNK-treated patients. The results from ongoing TNK trials in larger patient cohorts and in wake-up stroke populations will be instrumental to the wide-scale utilization of TNK in acute AIS management.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Factors associated with functional disability in patients with acute stroke excluded from alteplase administration due to minor non-disabling neurological deficits. (Pubmed Central) - Jan 10, 2023
In the multivariate regression analysis, NIHSS per 1-point increase, presenting as moderate motor weakness, and LAD were independent predictors of poor functional outcome (OR, 1.811 NIHSS per 1-point increase; 95% confidence interval [CI], 1.503-2.182; P < 0.0001; OR, 2.173 moderate motor weakness; 95% CI 1.028-4.595; P = 0.042; OR, 2.033 LAD; 95% CI 1.099-3.762; P = 0.024, respectively). Moderate motor weakness presentation and LAD may be important factors associated with poor functional outcomes in patients with acute stroke excluded from alteplase administration due to mild symptoms.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: A study on endovascular treatment alone and bridging treatment for acute ischemic stroke. (Pubmed Central) - Jan 8, 2023
Although there was no difference in clinical efficacy and safety between the abovementioned two groups, treatment with IVT + EVT could increase the risk of bleeding compared to EVT. Moreover, in the 6-8 h subgroup, the efficacy of EVT alone was better than that of IVT + EVT.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Catheter-Directed Thrombolysis in Setting of Pulmonary Embolism and Paradoxical Embolism () - Jan 6, 2023 - Abstract #ISET2023ISET_309;
Using CDT with the EKOS Endovascular System (Boston Scientific) and alteplase, clots were lysed, and flow was restored in all vessels. This case demonstrates that CDT is a favorable option in patients with acute PE and multiple thromboembolisms that minimizes adverse effects associated with systemic thrombolytic administration.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SUBCLAVIAN, VERTEBRAL AND INTERNAL MAMMARY ARTERIAL THROMBOSIS WITH PULMONARY EMBOLISM COMPLICATING COVID-19 INFECTION (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_7110;
In Conclusion, it is crucial to predict, avoid and promptly treat any thromboembolic events in patients with a recent history of COVID-19 infection presenting with unusual limb pain. Although COVID-19 primarily affects the lungs, it may also have unusual presentations due to thromboembolic compilations in unusual sites, such as in the subclavian artery, leading to acute limb ischemia and gangrene.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SIMULTANEOUS ARTERIAL AND VENOUS THROMBOEMBOLISM (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_6995;
It is rare for venous and arterial thromboembolic diseases to manifest simultaneously in the absence of vascular shunt. In such case, while undergoing management with anticoagulation, underlying conditions such as the antiphospholipid syndrome, malignancy, hyperhomocysteinemia, and infection must be evaluated.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
DYNAMIC AORTIC REGURGITATION IN PROSTHETIC VALVES - AN OMINOUS SIGN (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_6850;
In such case, while undergoing management with anticoagulation, underlying conditions such as the antiphospholipid syndrome, malignancy, hyperhomocysteinemia, and infection must be evaluated. Presence of dynamic intravalvar AR is an uncommon finding and it should point towards the possibility of prosthetic valve thrombosis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
MECHANICAL TRICUSPID VALVE THROMBOSIS TREATED WITH LOW DOSE ALTEPLASE (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_6796;
The current mechanical TV thrombosis management is based on expert clinical opinion and case series. This case depicts a single low-dose tPA administration as an effective management option in high-risk patients with nonobstructive TV thrombosis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
MECHANICAL VALVE THROMBOSIS CAUSING OBSTRUCTIVE SHOCK IN PREGNANCY (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_6589;
It can be difficult to treat with surgical methods due to high maternal and fetal mortality. However, repeat administration of low dose slow infusion tPA has a better safety profile than surgery and has proven efficacy in these situations.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
THROMBOLYSIS WITH SEVERE THROMBOCYTOPENIA, A POTENTIAL LIFE-SAVING TREATMENT IN MASSIVE PULMONARY EMBOLISM (eAbstract Site) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_6285;
Soon, she developed cardiac arrest.Decision?making: During resuscitation (CPR), in the patient's best interest, IV Alteplase 50 mg was given. Thrombolysis can be considered a rescue treatment in cardiac arrest secondary to massive PE regardless of platelet count if other options are unavailable or inaccessible.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SUCCESSFUL THROMBOLYSIS OF AN INTERATRIAL THROMBUS DURING WATCHMAN LAAO (eAbstract Site) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_2300;
Thrombolysis can be considered a rescue treatment in cardiac arrest secondary to massive PE regardless of platelet count if other options are unavailable or inaccessible. Transpetal puncture can result in interatrial thrombus formation which can be treated with systemic thrombolytic therapy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
EFFUSIVE CONSTRICTIVE PERICARDITIS, A HEART FAILURE MIMICKER (Poster Hall_Hall F) - Jan 4, 2023 - Abstract #ACCWCC2023ACC_WCC_1854;
Background: Effusive constrictive pericarditis can initially mimic heart failure and ultimately result in cardiogenic shock.Case: Patient is a 57-year-old female with history of recent massive pulmonary embolism status post systemic alteplase, chronic diastolic heart failure, and history of COVID-19 infection presenting with increasing dyspnea on exertion and weakness despite compliance to outpatient diuretics. Effusive constrictive pericarditis can mimic heart failure and should be ruled out in those with evidence of low cardiac output to avoid cardiovascular morbidity and mortality.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Alteplase associated Orolingual angioedema: A case report and literature review. (Pubmed Central) - Jan 4, 2023
Effusive constrictive pericarditis can mimic heart failure and should be ruled out in those with evidence of low cardiac output to avoid cardiovascular morbidity and mortality. Before intravenous thrombolytic therapy, patients should be asked if they have a history of allergies, are currently using ACEI, and try to avoid using ACEI antihypertensive drugs before and after thrombolytic therapy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Rescue stenting after the failure of intravenous thrombolysis and bridging thrombolysis: an initial Vietnamese report. (Pubmed Central) - Jan 3, 2023
Before intravenous thrombolytic therapy, patients should be asked if they have a history of allergies, are currently using ACEI, and try to avoid using ACEI antihypertensive drugs before and after thrombolytic therapy. Rescue stenting appears to represent an additional therapeutic option in cases that fail to resolve with IV alteplase, which may improve clinical outcomes.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Regional catheter thrombolysis for late proximal deep vein thrombosis (Pubmed Central) - Dec 31, 2022
The obtained data on the efficacy and safety profile correlate with previously published register studies of alteplase in AI. Thrombolysis with alteplase is safer and more effective compared to urokinase.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal, Head-to-Head: Intravenous tenecteplase compared with alteplase for acute ischemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. (Pubmed Central) - Dec 29, 2022
Resources are limited and inefficiently used. No abstract available
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Real-world evidence, Real-world: Alteplase Treatment in Elderly Acute Ischaemic Stroke (AIS) Patients (clinicaltrials.gov) - Dec 23, 2022
P=N/A, N=2500, Completed,
Moreover, the ease of administration and better pharmacodynamic properties favors tenecteplase. Active, not recruiting --> Completed
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