- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Enrollment change: Assess the Penumbra System in the Treatment of Acute Stroke (clinicaltrials.gov) - Sep 22, 2020
P4, N=108, Completed,
Not yet recruiting --> Recruiting Active, not recruiting --> Completed | N=692 --> 108
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: In What Scenarios Does a Mobile Stroke Unit Predict Better Patient Outcomes?: A Modeling Study. (Pubmed Central) - Sep 16, 2020
Conclusions- There are few scenarios where MSU transport predicts substantially superior outcomes to the mothership method when the MSU is dispatched from the endovascular therapy center. Outcomes using the MSU are maximized when dispatch criteria that maximize patients eligible for thrombolysis treatment are used and treatment times on the MSU are short relative to those of the endovascular therapy center.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial initiation date, Trial primary completion date: AtTAC: Impact of Tissue Plasminogen Activator (tPA) Treatment for an Atypical Acute Respiratory Distress Syndrome (COVID-19) (clinicaltrials.gov) - Sep 16, 2020
P3, N=50, Not yet recruiting,
Outcomes using the MSU are maximized when dispatch criteria that maximize patients eligible for thrombolysis treatment are used and treatment times on the MSU are short relative to those of the endovascular therapy center. Trial completion date: Nov 2020 --> Feb 2021 | Initiation date: Jul 2020 --> Oct 2020 | Trial primary completion date: Oct 2020 --> Jan 2021
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment change, Trial withdrawal: Study of Sodium Bicarbonate in Restoring Blocked Catheters (clinicaltrials.gov) - Sep 14, 2020
P2, N=0, Withdrawn,
Trial completion date: Nov 2020 --> Feb 2021 | Initiation date: Jul 2020 --> Oct 2020 | Trial primary completion date: Oct 2020 --> Jan 2021 N=608 --> 0 | Not yet recruiting --> Withdrawn
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Comparison of Clevidipine and Nicardipine for Acute Blood Pressure Reduction in Patients With Stroke. (Pubmed Central) - Sep 13, 2020
There was no difference in the mean time from initiation of the infusion to the SBP goal between agents or in the secondary outcomes. Due to the lack of differences observed, each agent should be considered based on the patient care needs of the institution.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Bedside diagnosis and treatment of high risk pulmonary embolism using cardiac ultrasound. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_397;
Thrombolysis is the first-line treatment for high-risk pulmonary embolism in combination with anticoagulant (unfractionated heparin). Transthoracic ultrasound is an essential tool to the emergency physician and allows to detect signs of acute pulmonary heart in any unstable patient suspected of pulmonary embolism and to initiate thrombolysis.
- |||||||||| Fortelyzin (recombinant staphylokinase) / Supergene
Trial completion date, Trial primary completion date: Single Bolus Recombinant Nonimmunogenic Staphylokinase (Fortelyzin) and Bolus Infusion Alteplase in Patients With AIS (clinicaltrials.gov) - Sep 10, 2020
P3, N=336, Recruiting,
Transthoracic ultrasound is an essential tool to the emergency physician and allows to detect signs of acute pulmonary heart in any unstable patient suspected of pulmonary embolism and to initiate thrombolysis. Trial completion date: Dec 2018 --> Dec 2020 | Trial primary completion date: Dec 2018 --> Sep 2020
- |||||||||| Aggrastat (tirofiban) / Correvio, Medicure, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment change, Trial termination: Tirofiban for Patients Treated With Alteplase (clinicaltrials.gov) - Sep 9, 2020
P2/3, N=30, Terminated,
N=40 --> 4 | Trial completion date: Apr 2022 --> Apr 2021 | Not yet recruiting --> Suspended | Trial primary completion date: Apr 2021 --> Apr 2020 N=220 --> 30 | Recruiting --> Terminated; The number and speed of enrollment were significantly less than expected.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
BUSTING THE CLOT BURDEN: THE IMPLEMENTATION OF A SLOW THROMBOLYTIC THERAPY PROTOCOL IN THE TREATMENT OF ACUTE MECHANICAL VALVE THROMBOSIS (ePoster Screen 11) - Sep 7, 2020 - Abstract #CCCCanada2019CCC_Canada_553;
METHODS/RESULTS : A retrospective chart review will be conducted to present the details of patients who underwent slow TT using a cyclical treatment of alteplase (TPA) and heparin infusions under echo guidance...CONCLUSION/IMPLICATIONS FOR PRACTICE : Raising awareness and education of the multidisciplinary team regarding TT for acute valve thrombosis is essential to ensure favourable patient outcomes. Cardiovascular nurses play a pivotal role in the safe implementation and patient monitoring during TT.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Pulmonary embolism or thrombosis in ARDS COVID-19 patients: A French monocenter retrospective study. (Pubmed Central) - Sep 5, 2020
Three patients were treated with alteplase and anticoagulation (n = 3/16, 19%) while the 13 others (n = 13/16, 81%) were treated with anticoagulation alone...The low rate of lower limb venous thrombosis together with the high rate of distal pulmonary thrombus argue for a local immuno-thrombotic process associated with the classic embolic process. Further larger studies are needed to assess the real prevalence and the risk factors of pulmonary embolism/thrombosis together with its prognostic impact on critically ill patients with COVID-19.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Are EMS bypass policies effective implementation strategies for intravenous alteplase for stroke? (Pubmed Central) - Sep 5, 2020
However, the effects of EMS bypass policies to increase intravenous alteplase use have not been rigorously evaluated. By learning how context and policy structures impact alteplase implementation, as well as the barriers and facilitators experienced by stakeholders responsible for policy enactment, the results of this study will inform decisions regarding if and how EMS bypass policies should spread to non-policy counties, and if indicated, creation of a "best practices" toolkit.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Rescue Therapy for Severe COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS) with Tissue Plasminogen Activator (tPA): A Case Series. (Pubmed Central) - Sep 2, 2020
Here we report a case series of five patients suffering from profound, medically refractory COVID-19 associated respiratory failure who were treated with fibrinolytic therapy using tissue plasminogen activator (tPA, Alteplase). All five patients appeared to have an improved respiratory status following tPA administration: one patient had an initial marked improvement that partially regressed after several hours, one patient had transient improvements that were not sustained, and three patients had sustained clinical improvements following tPA administration.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke. (Pubmed Central) - Sep 2, 2020
This finding may demonstrate a true benefit of IVT before EVT , but its interpretation is hampered by the possibility of residual confounding and selection bias. Randomized trials are required to properly assess the effect of IVT before EVT .
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland. (Pubmed Central) - Sep 1, 2020
This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic. (Pubmed Central) - Aug 27, 2020
A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy...After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p = 0.021) Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Telestroke in the Time of COVID-19: The Mayo Clinic Experience. (Pubmed Central) - Aug 15, 2020
The percentage of patients for whom we recommended urgent stroke treatment with intravenous alteplase, mechanical thrombectomy, or both decreased from 44.4% (28 of 63) to 33.3% (11 of 33). The reasons for the sunstantial decrease in telestroke activations and urgent stroke treatment recommendations are likely multifactorial but nevertheless underscore the importance of continued public health measures to encourage patients and families to seek emergency medical care at the time of symptom onset.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal, Pleural Effusion: Ways to overcome non-draining indwelling pleural catheter in malignant pleural effusion. (Pubmed Central) - Aug 14, 2020
After failing saline flushing and low-pressure wall suction, intrapleural alteplase was instituted through the IPC with a favourable outcome, and she continued to drain daily thereafter. The present case highlights the safety of intrapleural alteplase via IPC in the non-expandable lung.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. (Pubmed Central) - Aug 7, 2020
Best medical care including early intravenous thrombolysis, and successful and prompt recanalization achieved with mechanical thrombectomy, resulted in poor outcomes in patients with COVID-19. Although our results require further confirmation, a different pharmacological approach (antiplatelet or other) should be investigated to take in account inflammatory and coagulation disorders associated with COVID-19.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial suspension: A Study in Healthy Men to Compare 2 Different Formulations of Alteplase (clinicaltrials.gov) - Aug 7, 2020
P1, N=60, Suspended,
Although our results require further confirmation, a different pharmacological approach (antiplatelet or other) should be investigated to take in account inflammatory and coagulation disorders associated with COVID-19. Recruiting --> Suspended
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Field triage for endovascular stroke therapy: a population-based comparison. (Pubmed Central) - Aug 5, 2020
Recruiting --> Suspended In a densely populated setting, for patients with stroke who are EVT candidates and closest to a PSC from the field, triage to a slightly more distant CSC is associated with faster time to EVT, no delay to alteplase, and less disability at 90 days.
- |||||||||| Brilinta (ticagrelor) / AstraZeneca
Clinical, Journal: The Bleeding Safety of Ticagrelor in Patients With ST-Elevation Acute Coronary Syndrome Treated With Fibrinolytic Therapy (Pubmed Central) - Jul 30, 2020
Primary endpoint was hemorrhage associated with TLT; patients were followed up for 30 days.Results During the follow-up period, TLT-associated hemorrhages were observed in 11.3% of patients in the ticagrelor treatment group and in 10.7% of patients in the clopidogrel treatment group (p=0.9; odds ratio, 1.06 at 95 % confidence interval, from 0.41 to 2.73). Intracranial hemorrhages and fatal hemorrhages were absent in both groups.Conclusion There were no significant differences in hemorrhagic safety between patients with STEACS after the TLT treatment with alteplase and early treatment with ticagrelor or clopidogrel.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window. (Pubmed Central) - Jul 25, 2020
Intracranial hemorrhages and fatal hemorrhages were absent in both groups.Conclusion There were no significant differences in hemorrhagic safety between patients with STEACS after the TLT treatment with alteplase and early treatment with ticagrelor or clopidogrel. IVT in patients with AIS with unknown symptom onset time or elapsed time from symptom onset >4.5 hours selected with advanced neuroimaging results in a higher likelihood of CR and functional improvement at 3 months despite the increased risk of sICH.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: Intracranial Collaterals in Acute Stroke and Clinical Outcome (clinicaltrials.gov) - Jul 21, 2020
P=N/A, N=30, Recruiting,
IVT in patients with AIS with unknown symptom onset time or elapsed time from symptom onset >4.5 hours selected with advanced neuroimaging results in a higher likelihood of CR and functional improvement at 3 months despite the increased risk of sICH. Trial completion date: Mar 2020 --> Feb 2021 | Trial primary completion date: Feb 2020 --> Jan 2021
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy. (Pubmed Central) - Jul 17, 2020
Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria...At different phases of stroke care, different blood pressure targets are recommended. This narrative review will focus on the anesthesia and critical care providers' roles in the management of both perioperative stroke and acute ischemic stroke with a focus on anesthetic management for mechanical thrombectomy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Using LEAN methodology to expedite the treatment of acute ischemic stroke in the emergency room. (Pubmed Central) - Jul 16, 2020
The authors explain how a process improvement team utilized LEAN methodology to decrease alteplase administration ("door to needle") time by almost 50% at a busy, high-acuity hospital emergency room in Houston, Texas. The authors will explain the process that was followed, the post-implementation results, and lessons learned.
- |||||||||| Lucentis (ranibizumab) / Roche, Novartis, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Trial completion date: TAPAS: Intravitreal tPA and C3F8 for the Treatment of Submacular Haemorrhage as a Complication of Neovascular AMD (clinicaltrials.gov) - Jul 14, 2020
P2/3, N=55, Completed,
Mean cumulative Alteplase dose 6.36 mg. Active, not recruiting --> Completed | Trial completion date: May 2020 --> Dec 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open: A Study in Healthy Men to Compare 2 Different Formulations of Alteplase (clinicaltrials.gov) - Jul 12, 2020
P1, N=60, Recruiting,
Active, not recruiting --> Completed | Trial completion date: May 2020 --> Dec 2019 Not yet recruiting --> Recruiting
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion: TOSSI: Thrombolysis Outcome in Ischemic Stroke (clinicaltrials.gov) - Jul 9, 2020
P=N/A, N=214, Completed,
Hence, the use of each one of the two medicines depends on price, facility, and accessibility of the medicine. Recruiting --> Completed
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