- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
First Reported Case of Tenecteplase for Treatment of Acute Ischemic Stroke in Pregnancy (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2043;
We believe this is one of the first reported cases of TNK administration for acute ischemic stroke in pregnancy. As more medical centers transition to TNK for intravenous thrombolysis in acute ischemic stroke, it is important that we continue to report and evaluate safety outcomes for mother and fetus.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial suspension, Trial primary completion date: FIVHeMA: Intraventricular Fibrinolysis for Aneurysmal Subarachnoid Hemorrhage. (clinicaltrials.gov) - Mar 5, 2024
P3, N=440, Suspended,
Terminated --> Completed | Phase classification: P2b/3 --> P2/3 Trial completion date: Jan 2025 --> Mar 2024 | Recruiting --> Suspended | Trial primary completion date: Jul 2024 --> Mar 2024
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
Journal: A bibliometric analysis of tenecteplase research utilizing a commonly used citation index. (Pubmed Central) - Mar 4, 2024
Trial completion date: Jan 2025 --> Mar 2024 | Recruiting --> Suspended | Trial primary completion date: Jul 2024 --> Mar 2024 Through the use of bibliographic analysis and data visualization, we identified major articles and journals that reflected and shaped the current landscape of tenecteplase; recognized authors who engaged in tenecteplase research as it progressed from cardiopulmonary disease to stroke; and postulated future avenues of research.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Thrombus migration in emergent M1 middle cerebral artery occlusion. (Pubmed Central) - Mar 4, 2024
Through the use of bibliographic analysis and data visualization, we identified major articles and journals that reflected and shaped the current landscape of tenecteplase; recognized authors who engaged in tenecteplase research as it progressed from cardiopulmonary disease to stroke; and postulated future avenues of research. Thrombus migration within the M1 MCA segment occurs in almost a quarter of patients, is associated with alteplase administration, and is mainly irrelevant to radiological and clinical outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Retrospective data, Review, Journal: Can the combination of antiplatelet or alteplase thrombolytic therapy with argatroban benefit patients suffering from acute stroke? a systematic review, meta-analysis, and meta-regression. (Pubmed Central) - Mar 2, 2024
Thrombus migration within the M1 MCA segment occurs in almost a quarter of patients, is associated with alteplase administration, and is mainly irrelevant to radiological and clinical outcome. The results of this study suggest that further research into combination therapy with argatroban and antiplatelet agents may be warranted, however more rigorous RCTs are needed to definitively evaluate the effects of combination treatment.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Enrollment change, Trial completion date, Trial primary completion date: DISTAL-IVT: Early Recanalization After Intravenous Thrombolysis With Tenecteplase Versus Alteplase in Distal Vessel Occlusion Strokes (clinicaltrials.gov) - Feb 29, 2024
P=N/A, N=481, Recruiting,
The results of this study suggest that further research into combination therapy with argatroban and antiplatelet agents may be warranted, however more rigorous RCTs are needed to definitively evaluate the effects of combination treatment. Completed --> Recruiting | N=172 --> 481 | Trial completion date: Feb 2023 --> Dec 2024 | Trial primary completion date: Feb 2023 --> Dec 2024
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke. (Pubmed Central) - Feb 21, 2024
We recommend that patients with suspected acute lacunar ischaemic stroke receive intravenous alteplase, antiplatelet drugs and avoid blood pressure lowering according to current acute ischaemic stroke guidelines...We cannot make any recommendation concerning progressive stroke or other drugs. Large randomised controlled trials with clinically important endpoints, including cognitive endpoints, are a priority for lacunar ischaemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
All That Tingles: A Case of Progressive Paralysis and Fatal Pulmonary Embolism (San Diego Convention Center, Room 31A-C (Upper Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_8108;
50mg alteplase was administered, leading to a return of spontaneous circulation...Given the recent Zika virus outbreak in Brazil and the well-documented link between GBS and Zika virus infection, the potential role of these infections as etiological factors cannot be dismissed. This case accentuates the heightened risk of GBS in regions with a high prevalence of such infections, underscoring the importance of considering less common causes of infection-related autoimmune neuropathies in the differential diagnosis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Production and Characterization of Alteplase and Urokinase Loaded Echogenic Liposomal Carriers for Emphyema (San Diego Convention Center, Area L (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_6587;
When bound to fibrin, they do not interfere with fibrinolysis and retain relatively high levels of encapsulated enzymes protected from endogenous inhibitors, including PAI-1. TUELIP represent a novel candidate adjunct for fibrinolytic therapy where delivery to fibrin, and extended half-life of plasminogen activators known for optimized TELIP are complemented with the high specific PA activity of uPA.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Combination of Surgical Decortication and Post-operative Intrapleural Fibrinolysis Approach in Management of a Challenging Empyema Case (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_6136;
Two cycles of daily intrapleural fibrinolysis with alteplase and dornase alfa were performed, the first round to the right upper anterior chest tube and the second round to the right lateral lower chest tube...Despite current suggestion to use this modality to reduce surgical decortication, there has been no protocol for post-operative intrapleural fibrinolysis. Establishment of a global registry to assess the intrapleural microenvironment to optimize post-operative intrapleural fibrinolysis is warranted.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Oscillating Eyes: A Clue to an Uncommon Stroke Presentation (San Diego Convention Center, Area E (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_5942;
Description: Sixty-year-old male with a remote history of stroke, hypertension, hyperlipidemia, and atrial flutter on warfarin presented with double vision, dizziness, and gait unsteadiness...After treatment with alteplase for stroke patient was started on apixaban for atrial flutter anticoagulation apart from aspirin and atorvastatin...This is unique in its rare manifestation of oscillopsia as a presenting symptom of posterior circulation stroke. This further emphasizes the importance of thorough history-taking and physical examination.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Increased Coagulability With Nebulized TXA (San Diego Convention Center, Area E (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_3581;
This is supported by improvement after instillation of alteplase, a clot busting medication. As nebulized TXA becomes utilized more frequently these complications will become more evident, a discord should occur in the pulmonary community regarding the potential harms of nebulized TXA.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Late Isolated Pleural Recurrence of Cutaneous Melanoma (San Diego Convention Center, Area G (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_2232;
Patient was treated with 3 days of intrapleural fibrinolytics daily (alteplase 10mg and dornase alfa 5mg) with complete resolution of pleural effusion...Surveillance monitoring and prognostic factors need to be evaluated to better stratify a patient's risk of developing recurrence. Patients with unexplained lymphocytic predominant exudative effusion with prior history of melanoma should be investigated thoroughly for possible reoccurrence of malignancy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Don't Staph on My Heart and Strep Away My Lungs (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_2011;
A 34-year-old female with polysubstance IVDU on methadone, Crohn's disease presented 26-weeks pregnant with dyspnea and right-sided abdominal pain...Another pigtail catheter was placed with another course of alteplase/dornase but she ultimately required VATS and decortication...Anchoring the diagnosis in only the blood culture without consideration for other potential sources of infection may lead to undertreatment and persistent infection. It is essential to choose an appropriate antibiotic regimen that adequately covers all involved organisms and obtain source control in polymicrobial infections.
- |||||||||| Jcovden (COVID-19 vaccine (Ad26.COV2-S [recombinant])) / J&J
Janssen Covid-19 Vaccine: Case of Thrombosis With Thrombocytopenia Syndrome in a Male Patient (San Diego Convention Center, Area F (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1794;
The patient remained hospitalized for 6 days and discharged home with Xarelto and close follow-up...Given the discussions of the Jannsen vaccine link to elevated risk of spontaneous thrombotic events and the extent of his pulmonary embolism and lack of risk factors, it is highly likely that the Jannsen vaccine played a role in the patient's presentation. Understanding of the risks involved and discussion with patients is vital in early detection of vaccine induced thrombotic events.
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
How Many Times Must We Rule Out Pulmonary Embolism? A Representative Case (San Diego Convention Center, Area F (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1791;
In the MICU, the patient was started on empiric antibiotics, lactulose, and rifaximin...Full-dose systemic alteplase for lysis was administered followed by IV heparin...Vigilance is required to maintain a high index of suspicion for thromboembolism when risk factors are present, even with prior negative testing. This case shows the pitfalls of closure bias and the need for consistent reassessment when patients do not clearly fit a clinical picture.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A Question of Anticoagulation: Mortality of Pulmonary Embolism in the Intensive Care Unit (San Diego Convention Center, Area F (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1757;
3%) received alteplase, and 1(<1%) received neither drug...Given the breadth of data in this dataset, next steps for analysis of this population could include machine learning modelling to create new clinical prediction tool. The analysis was limited by a small sample size and that the population was only of patients at a single tertiary care center in Boston.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
A Comparison of Catheter-based Interventions for Management of Intermediate and High-risk Pulmonary Embolism in a Community Hospital (San Diego Convention Center, Area F (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1745;
CDT was done using EKOS [2 catheters, alteplase infusion at 1mg/hr for 12 hours (N=5) or 0... While our results show slight benefit with PMT with improved hemodynamics after 24 hours as well as less requirement for ICU stay and shorter LOS, more major bleeding episodes occurred, with 2 of the 3 episodes occurring with the Penumbra device.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Loculated Rheumatoid Effusions Treated With Alteplase-dornase (San Diego Convention Center, Area A (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1562;
With recent trials, a role of fibrinolytic has been established in complicated pleural effusions secondary to infections but the role of such therapies in noninfectious causes such as rheumatoid arthritis has not been well established, likely because of the rarity of the diseases. This case adds to the literature on the treatment of loculated effusions secondary to RA with fibrinolytics.
- |||||||||| Idhifa (enasidenib) / BMS, Servier
Loculated Pleural Effusion Due to Differentiation Syndrome in a Patient With Acute Myeloid Leukemia on Enasidenib (San Diego Convention Center, Area C (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1523;
Intravenous dexamethasone is the mainstay of treatment with consideration of stopping the offending agent...Alteplase and dornase was subsequently instilled yielding another 1,550 mL of fluid...Additionally, pleural fluid cytology as seen in this case has not been described in existing literature but may help guide diagnosis of DS. Larger observational cohort studies are needed to better characterize this complication.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Intrapleural Fibrinolytic Therapy in Loculated Malignant Pleural Effussion: A Case Series (San Diego Convention Center, Area C (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1455;
Fibrinolytic dosing was standardized at 10 mg alteplase and 5 mg DNase twice daily for 3 days in the intention-to-treat (ITT) population...Although the resolution of loculated MPE did not enhance overall 28-day survival, mortality remains largely determined by cancer stage. Consequently, IPFT should be considered as a palliative treatment strategy for managing loculated MPE to alleviate associated symptom burden.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Pulmonary Artery Catheter Directed Alteplase Infusion to Treat Prosthetic Mitral Valve Thrombosis in a Patient on ECMO (San Diego Convention Center, Area K (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1281;
We describe a unique case of prosthetic MV thrombosis successfully treated with thrombolytic therapy in a patient with cardiogenic shock on VA-ECMO after acute MI with heparin-induced thrombocytopenia. This case supports the use of directed fibrinolytic therapy in conjunction with ECMO as well as potential standalone therapy to treat MV thrombosis in patients with high surgical risk.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Systematic approach to obtain axillary arterial access for pediatric heart catheterizations. (Pubmed Central) - Feb 15, 2024
We infiltrated per-operatively 2% lignocaine (10?mg) for arterial spasms, long sheaths use (?5?Fr), and ?60?min procedures in <3?kg patients...There were two self-resolving arterial dissections, one sub-occlusive arterial thrombosis (resolved with 6 weeks of enoxaparin), and one occlusive arterial thrombosis (resolved with alteplase thrombolysis and 6 weeks of enoxaparin)...Four patients with complex univentricular hearts died from non-procedural causes at a median of 40 days (IQR, 31-161) postoperative. Systematic approach for AAA is the key to success and unlocks the many potentials of trans-axillary pediatric cardiology interventions.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Review, Journal: Prehospital Fibrinolysis Therapy in Acute Myocardial Infarction: A Narrative Review. (Pubmed Central) - Feb 12, 2024
Endovascular treatment improved postoperative outcomes. Our search strategy included the following terms: "Prehospital," "EMS," "Emergency Medical Services," "ambulance," "Fibrinolytic Therapy," "alteplase," "streptokinase," "reteplase," "tenecteplase," "Acute Myocardial Infarction," and "patient outcomes." We found prehospital administration of fibrinolysis may improve the outcomes and decrease the
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Comparing Low- or Standard-Dose Alteplase in Endovascular Thrombectomy: Insights From a Nationwide Registry. (Pubmed Central) - Feb 5, 2024
The results were consistent across predefined subgroups and age strata. Despite the lower rate of successful reperfusion and higher risk of symptomatic intracerebral hemorrhage with standard-dose alteplase, standard-dose alteplase was associated with a better functional outcome in patients receiving combined thrombolysis and thrombectomy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. (Pubmed Central) - Feb 1, 2024
We pooled individual patient data from the MISTIE III (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation Phase 3) and the ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage-2) trials...In secondary analyses, ICH volume of ?17.3 mL was associated with an increased risk of ischemic stroke (hazard ratio, 2.5 [95% CI, 1.1-7.2]), compared with those with an ICH volume <17.3 mL. In a heterogeneous cohort of patients with ICH, initial hematoma volume was associated with a heightened short-term risk of ischemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Parabiosis Discriminates the Circulating, Endothelial, and Parenchymal Contributions of Endogenous Tissue-Type Plasminogen Activator to Stroke. (Pubmed Central) - Jan 30, 2024
Intravenous injection of alteplase, a recombinant tPA (tissue-type plasminogen activator) as a thrombolytic agent has revolutionized ischemic stroke management...Together, our data reveal that during thromboembolic stroke, endogenous circulating tPA from endothelial cells sustains a spontaneous recanalization and reperfusion of the tissue, thus, limiting the extension of ischemic lesions. In this context, the impact of endogenous parenchymal tPA is limited.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Specific inhibition on PAI-1 reduces the dose of Alteplase for ischemic stroke treatment. (Pubmed Central) - Jan 29, 2024
In addition, PAItrap4 does not compromise the normal blood coagulation function in mice, demonstrating its safety as a therapeutic agent. These findings highlight this combination therapy as a promising alternative for the treatment of ischemic stroke, offering improved safety and efficacy.
- |||||||||| Aggrastat (tirofiban) / Correvio, Medicure, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
INTRACORONARY THROMBOLYSIS FOR RESCUE OF REFRACTORY LARGE THROMBUS BURDEN (Hall B4-5) - Jan 26, 2024 - Abstract #ACC2024ACC_6757;
Intracoronary thrombolysis can be helpful in these refractory cases. Long term anticoagulation may play an important role in preventing recurrent thrombosis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
CARDIO-CEREBRAL-INFARCTION OR CEREBRO-CARDIAC INFARCTION - A CHICKEN OR EGG CAUSALITY DILEMMA (Hall B4-5) - Jan 26, 2024 - Abstract #ACC2024ACC_5740;
We describe a case in which management of AIS via Alteplase (tPA) did not support resolution of MI.Case: An 80-year-old presented with fatigue... There are 3 key features of this case which are noteworthy: 1) synchronous onset of symptoms of AIS and MI, 2) ineffectiveness of AIS tPA protocol on cardiac thrombolysis, and 3) deficient management guidelines for such a case scenario.Future studies are needed to determine optimal management strategies in patients with CCI, especially if contraindication for tpA is given.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
BREATHING EASY AGAIN - EXPLORING THE FULL ARSENAL OF PE TREATMENT (Hall B4-5) - Jan 26, 2024 - Abstract #ACC2024ACC_4116;
Multiple therapeutic modalities exist for pulmonary embolism. Conservative anticoagulation is often insufficient, requiring more advanced therapies to improve morbidity and mortality.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
STRANGE RETURNS: ACQUIRED PULMONARY VENOUS COLLATERALS RESULTING IN RECURRENT SYNCOPE (Hall B4-5) - Jan 26, 2024 - Abstract #ACC2024ACC_3813;
We present a unique case of acquired right to left collateralization secondary to ICD implantation with resultant SVC thrombosis which resolved with conservative therapy. The shunt behaves like a VSD causing left ventricular dilation and concomitant hypoxia.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
OBSTRUCTIVE MECHANICAL VALVE THROMBUS DETECTION BY CARDIAC CT, TREATED WITH LOW DOSE THROMBOLYTICS (Hall B4-5) - Jan 26, 2024 - Abstract #ACC2024ACC_2509;
To determine the precise diagnosis, CT with delayed imaging should be utilized when obstructive valvular thrombosis is suspected. Treatment algorithms should include low-dose systemic thrombolysis, which is associated with improved survival over surgery.
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