- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
The role of E-FAST and thrombolysis in successful cardiopulmonary resuscitation () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_2160;
Patient was given 100mg dose of Alteplase as two 50mg boluses with ongoing chest compressions and other resuscitation drugs...She was followed up in the ambulatory care department after one week and further workup as outpatient for the reasons for patient having PE. This case study is a recent pragmatic example of early recognition of reversible causes of cardiac arrest, using E-FAST as the diagnostic tool for Pulmonary Embolism followed by decisive to use thrombolysis treatment in the ED, to continue prolong resuscitation efforts, effective team work supported by the Intensive care support that led to favourable patient's outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
The role of E-FAST and thrombolysis in successful cardiopulmonary resuscitation () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_2159;
Patient was given 100mg dose of Alteplase as two 50mg boluses with ongoing chest compressions and other resuscitation drugs...She was followed up in the ambulatory care department after one week and further workup as outpatient for the reasons for patient having PE. This case study is a recent pragmatic example of early recognition of reversible causes of cardiac arrest, using E-FAST as the diagnostic tool for Pulmonary Embolism followed by decisive to use thrombolysis treatment in the ED, to continue prolong resuscitation efforts, effective team work supported by the Intensive care support that led to favourable patient's outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
The role of E-FAST and thrombolysis in successful cardiopulmonary resuscitation () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_2158;
Patient was given 100mg dose of Alteplase as two 50mg boluses with ongoing chest compressions and other resuscitation drugs...She was followed up in the ambulatory care department after one week and further workup as outpatient for the reasons for patient having PE. This case study is a recent pragmatic example of early recognition of reversible causes of cardiac arrest, using E-FAST as the diagnostic tool for Pulmonary Embolism followed by decisive to use thrombolysis treatment in the ED, to continue prolong resuscitation efforts, effective team work supported by the Intensive care support that led to favourable patient's outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A rare case of pulmonary embolism presenting as bradycardia () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_1709;
A dignosis of acute pulmonary embolism was made and patient was thrombolysed with intra-arrest dose of alteplase an heparin...She remianed in ITU for 2 days and was discharged on warfarin with no neurological deficit...It also highlights the use of bedside point of care ultrasound in narrowing the differentials for cardiac arrest and confirmation of DVT, aiding in expediting the definitive treatment and improving patient's outcome. It also shows that althought DVT is most commonly found in the lower limbs and this is what most of the shock and cardiac arrest ultrasound protocol suggest to scan but one should have a lower threshold to scan upper limbs for DVT espcially when patients have AV -fistulas
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A rare case of pulmonary embolism presenting as bradycardia () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_1708;
A dignosis of acute pulmonary embolism was made and patient was thrombolysed with intra-arrest dose of alteplase an heparin...She remianed in ITU for 2 days and was discharged on warfarin with no neurological deficit...It also highlights the use of bedside point of care ultrasound in narrowing the differentials for cardiac arrest and confirmation of DVT, aiding in expediting the definitive treatment and improving patient's outcome. It also shows that althought DVT is most commonly found in the lower limbs and this is what most of the shock and cardiac arrest ultrasound protocol suggest to scan but one should have a lower threshold to scan upper limbs for DVT espcially when patients have AV -fistulas
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A rare case of pulmonary embolism presenting as bradycardia () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_1707;
A dignosis of acute pulmonary embolism was made and patient was thrombolysed with intra-arrest dose of alteplase an heparin...She remianed in ITU for 2 days and was discharged on warfarin with no neurological deficit...It also highlights the use of bedside point of care ultrasound in narrowing the differentials for cardiac arrest and confirmation of DVT, aiding in expediting the definitive treatment and improving patient's outcome. It also shows that althought DVT is most commonly found in the lower limbs and this is what most of the shock and cardiac arrest ultrasound protocol suggest to scan but one should have a lower threshold to scan upper limbs for DVT espcially when patients have AV -fistulas
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A rare case of pulmonary embolism presenting as bradycardia () - Oct 1, 2021 - Abstract #EUSEM2021EUSEM_1706;
A dignosis of acute pulmonary embolism was made and patient was thrombolysed with intra-arrest dose of alteplase an heparin...She remianed in ITU for 2 days and was discharged on warfarin with no neurological deficit...It also highlights the use of bedside point of care ultrasound in narrowing the differentials for cardiac arrest and confirmation of DVT, aiding in expediting the definitive treatment and improving patient's outcome. It also shows that althought DVT is most commonly found in the lower limbs and this is what most of the shock and cardiac arrest ultrasound protocol suggest to scan but one should have a lower threshold to scan upper limbs for DVT espcially when patients have AV -fistulas
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Preclinical, Journal: Comparative Assessment of the Proteolytic Stability and Impact of Poly-Arginine Peptides R18 and R18D on Infarct Growth and Penumbral Tissue Preservation Following Middle Cerebral Artery Occlusion in the Sprague Dawley Rat. (Pubmed Central) - Sep 29, 2021
The in vitro anti-excitotoxic neuroprotective efficacy of R18D was also demonstrated to be unaffected when preincubated for 1-3 h or overnight, in a cell lysate prepared from dying neurons or with the proteolytic enzyme, plasmin, whereas the neuroprotective efficacy of R18 was significantly reduced after a 2-h incubation. These findings highlight the capacity of poly-arginine peptides to reduce infarct growth and preserve the ischaemic penumbra, and confirm the superior efficacy and proteolytic stability of R18D, which indicates that this peptide is likely to retain its neuroprotective properties when co-administered with alteplase during thrombolysis for acute ischaemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Disseminated Intravascular Coagulation After Massive Pulmonary Embolism: Management Of Intraoperative Coagulopathy (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4455;
Treated with alteplase followed by mechanical thrombectomy due to partial response to fibrinolytic therapy...These findings were concerning for DIC versus residual fibrinolysis. Anticoagulation was discontinued, and the patient was transfused multiple blood products in the OR and postoperatively in the ICU.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Single- and two- chain tissue type plasminogen activator treatments differentially influence cerebral recovery after stroke. (Pubmed Central) - Sep 19, 2021
Tissue type Plasminogen Activator (tPA), named alteplase (Actilyse®) under its commercial form, is currently the only pharmacological treatment approved during the acute phase of ischemic stroke, used either alone or combined with thrombectomy...However, compared to sc-rtPA, tc-rtPA is less efficient to reduce lesion volumes and to improve functional recovery, and is associated with an increased opening of the blood brain barrier. These data indicate better understanding of differential effects of these tPA forms might be important to ultimately improve stroke treatment.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Enrollment change, Trial completion date: Intracranial Collaterals in Acute Stroke and Clinical Outcome (clinicaltrials.gov) - Sep 16, 2021
P=N/A, N=40, Completed,
The curative effect is related to age, diabetes history, vascular infarction site, and venous thrombolysis time. Recruiting --> Completed | N=30 --> 40 | Trial completion date: Feb 2021 --> Aug 2021
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Intracranial Pressure and Cerebral Perfusion Pressure in Large Spontaneous Intracranial Hemorrhage and Impact of Minimally Invasive Surgery. (Pubmed Central) - Sep 14, 2021
Post-hoc analysis of the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation (MISTIE III) study, a clinical trial with blinded outcome assessments...Long term mortality was significantly associated with higher proportion of time with ICP ≥ 20 (p = 0.04), ICP ≥ 30 (p = 0.04), and CPP <70 mmHg (p = 0.01). Our results are consistent with the hypothesis that surgical reduction of ICH volume decreases proportion of high ICP and low CPP events and that these variables are associated with short- and long-term mortality.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Direct costs of rescue procedures to manage vascular access complications in conventional hemodialysis. (Pubmed Central) - Sep 14, 2021
Our results are consistent with the hypothesis that surgical reduction of ICH volume decreases proportion of high ICP and low CPP events and that these variables are associated with short- and long-term mortality. Material and drug costs significantly contributed to the composition of the average total direct cost of most procedures.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Intraventricular Thrombolytic Use and Reduction of Parenchymal Hematoma Volume in the CLEAR III Trial () - Sep 10, 2021 - Abstract #NCS2021NCS_371;
Conclusions In this secondary analysis of the CLEAR III trial, intraventricular alteplase was associated with a small reduction in parenchymal ICH volume, highlighting a possible communication between the ventricular cavity and brain parenchyma. These results highlight exploring this novel treatment for decreasing ICH volume and potentially improving outcomes.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Intra-arterial Thrombectomy after Cardiac Arrest in the thrombectomy Suite () - Sep 10, 2021 - Abstract #NCS2021NCS_251;
IV Alteplase was contraindicated...Conclusions The case highlights that critical care efforts, even after a severe initial presentation, can lead to a successful thrombectomy, and that eligibility for thrombectomy can be reassessed as the patient stabilizes. It also shows that in chronically ill patients with limited life expectancies, such efforts can offer enough quality time with loved ones to make it a meaningful outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Fucoidan-functionalized polysaccharide submicroparticles loaded with alteplase for efficient targeted thrombolytic therapy. (Pubmed Central) - Sep 7, 2021
The experiments on the murine model of acute thromboembolic ischemic stroke support this product's therapeutic efficacy, revealing a faster recanalization rate in the middle cerebral artery than with free alteplase, which reduces post-ischemic cerebral infarct lesions and blood-brain barrier permeability. Altogether, this proof-of-concept study demonstrates the potential of a biomaterial-based targeted nanomedicine for the precise treatment of acute thrombotic events, such as ischemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Current State of Stroke Care in the Philippines. (Pubmed Central) - Sep 7, 2021
In terms of access to medicines, the government launched its stroke medicine access program (MAP) in 2016, providing more than 1,000 vials of recombinant tissue plasminogen activator (rTPA) or alteplase subsidized to selected government hospitals across the country...The lack of centralization and fragmentation of the stroke cases reporting system leads to reliance on data from hospital records or community-based stroke surveys, which may inaccurately depict the country's actual stroke incidence and prevalence. Based on these gaps, specific recommendations geared toward systems approach - governance, financing, information system, human resources for health, and medicines were identified.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
SARS-COV2 pneumonia associated with severe thrombolysis pulmonary embolism (Posters) - Sep 7, 2021 - Abstract #EUSEM2021EUSEM_791;
Current data suggests the existence of a highly procoagulant state during COVID-19 disease, which requires prophylactic anticoagulation at higher doses than usual, or even at therapeutic doses depending on the presence of certain risk factors. or significant hypercoagulability.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Point-of-care ultrasound-guided treatment of acute pulmonary embolism and complication follow-up: case report (Posters) - Sep 7, 2021 - Abstract #EUSEM2021EUSEM_703;
At the time of admission, he was on bridging therapy from low molecular weight heparin to warfarin...These findings were highly suggestive of an acute PE and the patient was immediately started on fibrinolytic therapy with intravenous alteplase 100mg, besides supplemental oxygen and fluid therapy, with subsequent improvement of hemodynamic status and peripheral oxygenation...Accordingly, to the European Society of Cardiology most recent guidelines, in a patient presenting with hemodynamic instability, bedside transthoracic echocardiography is recommended to assess the presence of right ventricle dysfunction and guide the start of fibrinolytic therapy. Besides, when point-of-care ultrasound is used as the fifth pillar of beside evaluation, it is also extremely useful in the monitoring of hemodynamic state and associated complications.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
The role of E-FAST and thrombolysis in successful cardiopulmonary resuscitation (Posters) - Sep 7, 2021 - Abstract #EUSEM2021EUSEM_246;
Patient was given 100mg dose of Alteplase as two 50mg boluses with ongoing chest compressions and other resuscitation drugs...She was followed up in the ambulatory care department after one week and further workup as outpatient for the reasons for patient having PE. This case study is a recent pragmatic example of early recognition of reversible causes of cardiac arrest, using E-FAST as the diagnostic tool for Pulmonary Embolism followed by decisive to use thrombolysis treatment in the ED, to continue prolong resuscitation efforts, effective team work supported by the Intensive care support that led to favourable patient's outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A rare case of pulmonary embolism presenting as bradycardia (Posters) - Sep 7, 2021 - Abstract #EUSEM2021EUSEM_133;
A dignosis of acute pulmonary embolism was made and patient was thrombolysed with intra-arrest dose of alteplase an heparin...She remianed in ITU for 2 days and was discharged on warfarin with no neurological deficit...It also highlights the use of bedside point of care ultrasound in narrowing the differentials for cardiac arrest and confirmation of DVT, aiding in expediting the definitive treatment and improving patient's outcome. It also shows that althought DVT is most commonly found in the lower limbs and this is what most of the shock and cardiac arrest ultrasound protocol suggest to scan but one should have a lower threshold to scan upper limbs for DVT espcially when patients have AV -fistulas
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] ACT-COG: ONLINE COGNITIVE ASSESSMENT IN THE ALTEPLASE COMPARED TO TENECTEPLASE STUDY () - Sep 6, 2021 - Abstract #ESOC2021ESOC_1782;
P3
It will test the hypothesis that dual thrombolytic therapy with a bolus alteplase and m-pro-urokinase reduces the occurrence of ICH in patients with ischemic stroke compared to patients treated with alteplase alone. Determining the feasibility of a simple, remote cognitive assessment for use in acute stroke trials could facilitate a platform to assess the impact of various stroke interventions on short- and long-term cognition.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] CLOT STRUCTURE AFFECTS THROMBOLYTIC SUSCEPTIBILITY TO ALTEPLASE IN VITRO () - Sep 6, 2021 - Abstract #ESOC2021ESOC_1756;
Densely packed plasma clots and semi-synthetic clots (erythrocytes 2.5*109/mL) showed the highest resistance to thrombolysis. The highest content of vWF in plasma clots may mediate resistance to thrombolysis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] CRYPTOGENIC ISCHEMIC STROKE: CAROTID WEB, A CASE SERIES () - Sep 6, 2021 - Abstract #ESOC2021ESOC_1447;
Both received intravenous alteplase and mechanical thrombectomy was performed with successful revascularization (TICI 3)... In our series both medical and endovascular treatment were safe and no recurrences were detected, nevertheles a longer follow up may be required.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] INTRACRANIAL ARTERY DISSECTION (IAD): IS THERE ANOTHER POSSIBLE THERAPEUTIC OPTION? () - Sep 6, 2021 - Abstract #ESOC2021ESOC_1392;
The thrombolytic therapy has not caused bleeding in small sample of examined pts., thus suggesting that it act on the thrombotic process, without affecting the integrity of the vessel wall, although the latter is poorly equipped with elastic fibers and easily vulnerable to any noxa, probably more traumatic than pharmacologic. The study of these few cases provides food for thought on alternative therapeutic options that could envisage, after large retrospective studies and specific trials, the use of thrombolysis also in intracranial vessels dissections.
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