- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment change: SITS_ELDERLY: SITS-IVT in Patients >80 Years Study (clinicaltrials.gov) - Jun 11, 2021
P=N/A, N=1000, Active, not recruiting,
There was no differences in MACE at one year suggesting no long-term clinical sequelae. N=2000 --> 1000
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Resistance to Fibrinolysis in Critically Ill Patients with COVID-19 Can Be Overcome by N-acetylcysteine in vitro (Room 1) - Jun 9, 2021 - Abstract #ISTH2021ISTH_2546;
A modified thromboelastography assay (ROTEM® Delta) using EXTEM® reagent and 150ng.mL-1 t-PA (Actilyse®) was performed in the presence of 10mM NAC or buffer...Conclusions : Resistance to fibrinolysis in critically ill COVID-19 patients is associated with thrombosis and clinical severity. NAC could represent a new adjunct therapy to promote endogenous fibrinolysis in severe COVID-19 patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Mechanical Prosthetic Valve Thrombosis in COVID-19 Infection: Case Report (Room 4) - Jun 9, 2021 - Abstract #ISTH2021ISTH_1783;
Conclusions : This case raises awareness to the catastrophic thrombosis of mechanical valve, presenting in an late phase of COVID-19 infection without the typical hyper-inflammation and severe lung injury associated with development of COVID-related coagulopathy. It also serves to inform on the critical role echocardiography has in the comprehensive evaluation and re-evaluation of hospitalized patients with COVID-19, and the importance of a multidisciplinary organized approach in clinical decision-making for this complex and poorly understood disease and its sequelae.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Heterozygosity for factor V Leiden with a Catastrophic Presentation (Room 3) - Jun 9, 2021 - Abstract #ISTH2021ISTH_1584;
Pulmonary embolism with obstructive shock was suspected and alteplase thrombolysis performed...There was a progressive clinical improvement under hypocoagulant treatment, first with low molecular weight heparin and later with apixaban, which she maintained after discharge.Following the acute event, thrombophilia study was performed and a heterozygosity for FVL diagnosed with genetic testing...Conclusions : A patient with heterozygosity for FVL, without a personal and family history of thrombosis, presents as an initial manifestation of a multifactorial disease a life-threatening event. With this case, we intend to highlight that, although rare, these severe events can unfortunately occur.
- |||||||||| enoxaparin sodium / Generic mfg.
[VIRTUAL] Management of Clot in Transit in a Postpartum COVID-19 Patient (Room 3) - Jun 9, 2021 - Abstract #ISTH2021ISTH_637;
She was anticoagulated with enoxaparin at 1mg/kg, but her oxygen requirements worsened requiring 100% FiO2 on the ventilator...Results : PERT team ultimately recommended 50mg alteplase be given systemically with family’s consent...CT Head reported no hemorrhage, and repeat CTPA showed near-complete resolution of RV thrombus. Conclusions : This case exemplifies the role of both emergent multidisciplinary decision-making in complex case scenarios, and systemic thrombolysis for the management of COVID-19 related CIT in patients who recently underwent cesarean delivery.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Resistance to Fibrinolysis in Critically Ill Patients with COVID-19 Can Be Overcome by N-acetylcysteine in vitro (Room 3) - Jun 9, 2021 - Abstract #ISTH2021ISTH_472;
A modified thromboelastography assay (ROTEM® Delta) using EXTEM® reagent and 150ng.mL-1 t-PA (Actilyse®) was performed in the presence of 10mM NAC or buffer...Conclusions : Resistance to fibrinolysis in critically ill COVID-19 patients is associated with thrombosis and clinical severity. NAC could represent a new adjunct therapy to promote endogenous fibrinolysis in severe COVID-19 patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Multiple Administrations of Intravenous Thrombolytic Therapy to a Stroke Mimic. (Pubmed Central) - Jun 8, 2021
We present a case of a stroke mimic patient with underlying psychiatric disease who was treated with intravenous alteplase on four separate occasions in four different emergency departments in the same city...WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Increased awareness of stroke mimics by emergency physicians may improve diagnostic safety for a subset of high-risk patients. Establishing rapid cross-institutional communication pathways that are integrated into provider's workflows to convey essential patient health information has potential to improve stroke diagnostic decision-making and thus represents an important topic for health systems research in emergency medicine.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Effect of alteplase versus aspirin plus clopidogrel in acute minor stroke. (Pubmed Central) - Jun 8, 2021
Asymptomatic ICH occurred in 0.8% patients who received aspirin-clopidogrel, as compared with 3.7% patients in alteplase group (p = .030). Patients treated with dual-antiplatelet therapy with acute minor ischemic stroke had greater functional outcome at 3 months compared with patients who received alteplase therapy.Classification of evidence: This study provides Class IV evidence that dual-antiplatelet therapy is superior to alteplase for achieving a better functional outcome and does not increase the risk of hemorrhage in acute minor ischemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Paroxysmal dystonia: a vascular event or epileptic seizure (Raum2) - May 30, 2021 - Abstract #EAN2021EAN_2103;
We present a case of posterior circulation stroke in combination with arm dystonia and cephalic rotation, an interesting phenomenology with a challenging aetiological diagnosis. Despite the potential of thalamic hypoperfusion causing dystonia, both semiology and MRI changes suggest that it was probably a result of an acute symptomatic seizure originated in the hippocampus, in the context of an ischaemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Gender differences and risk factors in intravenous thrombolysis; a year experience in Albania (Room Berlin) - May 30, 2021 - Abstract #EAN2021EAN_1931;
Background and aims: Intravenous thrombolysis with alteplase is the mainstay treatment for ischemic stroke within 4.5 hours of symptom onset in ischemic stroke... The outcomes of stroke patients undergoing thrombolysis vary on age but doesn’t seem to vary based on sex.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Off-label alteplase use in anterior spinal artery syndrome – a supportive case report (Room Seville) - May 30, 2021 - Abstract #EAN2021EAN_1529;
Intermittent catheterization, antiedematous treatment and secondary prevention with acetylsalicylic acid and atorvastatin were started, with slow progressive improvement. Despite the absence of formal approval, this case supports that off-label systemic thrombolysis could be safe and useful for the treatment of ASAS – warranting further investigation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] Cryptogenic ischemic stroke: carotid web, a case series (Main Auditorium) - May 30, 2021 - Abstract #EAN2021EAN_468;
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, nevertheless a longer follow up may be required.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Neutrophil gelatinase-associated lipocalin is a predictor of complications in the early phase of ST-elevation myocardial infarction. (Pubmed Central) - May 26, 2021
Methods A total of 54 patients with the diagnosis of STEMI treated with fibrinolytic therapy (alteplase) prior to PCI were included...In that group relative risk (RR) for lethal outcome was 6.4 times significantly higher (p=0.002), for the development of heart failure 2.88 times (p=0.0002), for post-myocardial infarction angina pectoris 2.24 times (p=0.0158), and for ventricular rhythm disturbances (ventricular tachycardia, ventricular fibrillation) 1.96 times higher (p=0.0108). Conclusion Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Effect of Acute Stroke Care Regionalization on Intravenous Alteplase Use in Two Urban Counties. (Pubmed Central) - May 25, 2021
Conclusion Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI. Our findings suggest that greater post-regionalization improvements in San Mateo County contributed to significantly better county-level thrombolysis use than Santa Clara County.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Journal, Video: Study protocol for DICE trial: Video-assisted thoracoscopic surgery decortication versus interventional radiology guided chest tube insertion for the management of empyema. (Pubmed Central) - May 20, 2021
Participants will be randomized into either interventional radiology guided chest tube insertion with intrapleural fibrinolytics (Dornase 5 mg and Alteplase 10 mg intrapleural twice daily for three days) or video-assisted thoracoscopic surgery (VATS) decortication...Secondary outcomes include a change in the size of empyema, length of stay, morbidity, as well as 30-day and 90-day mortality, as well as quality of life measurements. This study is aimed at identifying the most effective initial management option for individuals with empyema.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Journal: Low-Dose Alteplase for the Treatment of Submassive Pulmonary Embolism: A Case Series. (Pubmed Central) - May 15, 2021
The potential for low-dose tPA as a safe and efficacious treatment option for submassive PE is illustrated by this case series. However, larger, randomized controlled trials are needed to establish low-dose tPA as an accepted treatment modality.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Telestroke Program Participation and Improvement in Door-To-Needle Times. (Pubmed Central) - May 15, 2021
However, larger, randomized controlled trials are needed to establish low-dose tPA as an accepted treatment modality. All patients with a diagnosis of acute ischemic stroke, who underwent a telestroke consultation and received intravenous alteplase were included in the analysis...Telestroke network participation may be associated with improved acute stroke care metrics over time, with the analysis illustrating improved last-known normal to needle and door-to-needle times among participating spoke sites.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Preclinical, Journal: A murine photothrombotic stroke model with an increased fibrin content and improved responses to tPA-lytic treatment. (Pubmed Central) - May 15, 2021
Here we tested whether the admixture of thrombin (80 U/kg) and RB dye (50 mg/kg) in the proximal middle cerebral artery (MCA)-targeted PTS will modify the clot composition and elevate the responsiveness to tPA-lytic treatment (Alteplase, 10 mg/kg)...These results suggest that T+RB-PTS produces mixed platelet:fibrin clots closer to the clinical thrombus composition and enhanced the sensitivity to tPA-lytic treatment. As such, the modified photothrombosis may be a useful tool to develop more effective thrombolytic therapies of cerebral ischemia.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Impact of Stroke Center Certification on Thrombolysis Time Metrics in Telestroke Setting. (Pubmed Central) - May 15, 2021
As such, the modified photothrombosis may be a useful tool to develop more effective thrombolytic therapies of cerebral ischemia. The prospectively maintained data on all consecutive stroke patients who received intravenous alteplase (tissue plasminogen activator [tPA]) between July 2016 and November 2019 through a large telestroke program in Southeast United States was reviewed...In our study, PSCs had better performance in the procedural metrics for tPA administration than non-PSCs in a large contemporary telestroke cohort.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Observational data, Journal: Does Emergency Medical Services Transportation Mitigate Post-stroke Discharge Disability? A Prospective Observational Study. (Pubmed Central) - May 15, 2021
The prospectively maintained data on all consecutive stroke patients who received intravenous alteplase (tissue plasminogen activator [tPA]) between July 2016 and November 2019 through a large telestroke program in Southeast United States was reviewed...In our study, PSCs had better performance in the procedural metrics for tPA administration than non-PSCs in a large contemporary telestroke cohort. The findings offer evidence for including stroke education as a standard of care in the primary care management of patients with stroke-risk comorbidities/lifestyle in order to minimize post-stroke disability.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Statistical Analysis Plan for EXtending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND) trial. (Pubmed Central) - May 14, 2021
P3
Publication of a statistical analysis plan serves to reduce potential trial analysis and reporting bias and outlines pre-specified analyses to quantify the benefits and harms of extending the thrombolysis time window to 9 h from stroke onset and in wake-up stroke patients. Trial registration: ClinicalTrials.gov number NCT00887328 registered 23/Apr/2009 and NCT01580839 (EXTEND International) registered 19/Apr/2012.
- |||||||||| Zarzio (filgrastim biosimilar) / Novartis
[VIRTUAL] A YOUNG WOMEN WITH LIGNEOUS MEMBRANES WHO WANTS TO BE PREGNANT () - May 13, 2021 - Abstract #EHA2021EHA_2123;
Although a regular cavity view was achieved after FFP replacement therapy and local application, freeze embrional transfer was performed without a proper pregnancy achievement. Conclusion Gynecologists and clinicians who are familiar with this bizarre disease’s clinical and histopathologic features will diagnose timely and manage properly.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Observational data, Journal, Real-world evidence: Intravenous thrombolytic therapy with Revelisa of ischemic stroke in real-world clinical practice: interim results of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R (Pubmed Central) - May 5, 2021
33176180. The data obtained with the use of Revelisa in patients with ischemic stroke in real-world clinical practice allow drawing conclusions about a comparable safety and efficacy profile to that in previously published registry studies of alteplase.
- |||||||||| Eylea (aflibercept intravitreal) / Bayer, Regeneron, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Trial completion date, Trial initiation date, Head-to-Head: Vitrectomy, Subretinal Tissue Plasminogen Activator (TPA) and Intravitreal Gas for Submacular Haemorrhage Secondary to Exudative (Wet) Age-related Macular Degeneration (TIGER). (clinicaltrials.gov) - May 3, 2021
P3, N=210, Recruiting,
The data obtained with the use of Revelisa in patients with ischemic stroke in real-world clinical practice allow drawing conclusions about a comparable safety and efficacy profile to that in previously published registry studies of alteplase. Trial completion date: Aug 2025 --> Dec 2025 | Initiation date: Dec 2020 --> Apr 2021 | Not yet recruiting --> Recruiting
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal, Real-world evidence: "Real-World" Application of Thrombolysis in Cardiac Arrest. (Pubmed Central) - Apr 27, 2021
In a single center's experience, thrombolytic therapy is used infrequently for the management of cardiac arrest. Thrombolysis during cardiac arrest should be considered on a case-by-case basis and should be utilized only when there is a high suspicion for pulmonary embolism as the cause of arrest and when thrombolytic therapy is readily available.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Aminocaproic Acid for the Reversal of Alteplase: A Case Series. (Pubmed Central) - Apr 24, 2021
Cryoprecipitate was administered in 69% (11/16) of patients. There was no clear relationship between the timing or dose of aminocaproic acid and hemostasis, and it is unclear if administration of aminocaproic acid contributes to hemostasis.
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