- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open: STARS: Fibrinolytic Therapy to Treat ARDS in the Setting of COVID-19 Infection (clinicaltrials.gov) - May 22, 2020
P2a, N=60, Recruiting,
Although Tenecteplase is more easily administered as a single bolus and has a higher recanalization rate than Alteplase, randomized, double-blind, phase III clinical trials need to be conducted to prove efficacy and safety of its use in clinical practice. Not yet recruiting --> Recruiting
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Acute Ischemic Stroke: Acute Management and Selection for Endovascular Therapy. (Pubmed Central) - May 19, 2020
Acute management of patients suffering from acute ischemic stroke (AIS) requires early recognition of symptoms, rapid assessment and stabilization (hyperacute workup), and appropriate selection of patients for reperfusion with intravenous alteplase and/or mechanical thrombectomy. Established stroke protocols which involve both prehospital emergency medical services and in-hospital multidisciplinary stroke teams have been shown to be crucial to reducing the long term, devastating effects of stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Diagnosis, treatment & management of prosthetic valve thrombosis: the key considerations. (Pubmed Central) - May 15, 2020
Surgical treatment could be reserved in whom thrombolytic therapy is contraindicated, or has already failed. The efficacy and safety of thrombolytic therapy as compared to surgery should be confirmed with large observational cohorts, and ideally randomized trials.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Size Matters: Saving the Penumbra () - May 13, 2020 - Abstract #QCOR2020QCOR_123;
During this period, median alteplase treatment times were reduced by 51%, from 63 minutes (2014) to 31 minutes (2019). The percentage of patients who received alteplase in 45 minutes or less at NHRMC was 76% from 2016 - October 2019, compared to 44% nationally participating in the AHA/ASA Get with the Guideline Stroke registry.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Weekday Versus Weekend Presentation in the Acute Management of Ischemic Stroke Through Telemedicine. (Pubmed Central) - May 8, 2020
From October 2015 to June 2017, we reviewed patients with AIS receiving intravenous alteplase within our TS network...While there were no significant differences in outcomes, patients presenting on weekends had longer door-to-alert activation and door-to-needle times. Efforts to improve methods in efficiency of care on weekends should be considered.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion: Surgical Stabilizer Assisted RVC With rtPA for CRVO (clinicaltrials.gov) - May 7, 2020
P1, N=4, Completed,
Efforts to improve methods in efficiency of care on weekends should be considered. Not yet recruiting --> Completed
- |||||||||| nerinetide (NA 1) / NoNO, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Alteplase Inhibits Nerinetide, a Novel Stroke Drug. (Pubmed Central) - Apr 30, 2020
No abstract available No abstract available
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Pump Thrombosis, Scratching the Surface () - Apr 26, 2020 - Abstract #ISHLT2020ISHLT_1313;
In our institution, HeartWare HVAD patients with PT are thrombolysed with systemic Alteplase infusion until restoration of normal power consumption or maximum infusion duration of 20 hours...Whether this is due to impeller instability or other factors is unknown. Routine inspection of explanted pumps may provide insights into thrombosis mechanisms.
- |||||||||| Zarifa (tirofiban) / Orchid, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Hybrid Thrombolysis for Left Ventricular Assist Device Thrombosis () - Apr 26, 2020 - Abstract #ISHLT2020ISHLT_1231;
Duration of LVAD support preceding PT was 518 days (172, 920 days).All patients had significant increases in power and haemolysis markers, and were treated initially with heparin and tirofiban (n=9) or heparin alone (n=1)...The pigtail catheter was left in situ, and the alteplase maintenance infusion continued at 1mg/hour to a weight-adjusted maximum...Interpretation is limited by small group size and retrospective design. These outcomes require comparison with other approaches, ultimately in a randomised trial.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Pharmacological Treatment of Pump-Related Thrombosis in Patients with Left Ventricular Assist Device (HearWare HVAD) () - Apr 26, 2020 - Abstract #ISHLT2020ISHLT_871;
Pharmacological treatment was defined by the use of intravenous heparin alone or in association with systemic thrombolysis with tissue plasminogen activator, t-PA-Actiliyse or with left intraventricular thrombolysis with t-PA-Actilyse...Conclusion LVAD thrombosis is a major complication after LVAD implantation. Pharmacological conservative treatment with heparin or fibrinolysis could be the first line treatment before considering pump exchange or urgent heart transplant.
- |||||||||| Angiomax (bivalirudin) / Novartis
Clinical, Journal: Bivalirudin during thrombolysis with catheter-directed tPA in a heparin-refractory patient: A case report. (Pubmed Central) - Apr 23, 2020
We present a child in whom bivalirudin was used for systemic anticoagulation during catheter-directed thrombolysis along with tissue plasminogen activator (Alteplase ) for the treatment of a near-occlusive organ-threatening thrombus. We also review the currently available literature on the use of combination therapy of an intravenous direct thrombin inhibitor with alteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Intrapleural Tissue Plasminogen Activator for Traumatic Retained Hemothorax. (Pubmed Central) - Apr 22, 2020
Administration of intrapleural alteplase should be considered in patients with retained hemothorax as an alternative to surgical intervention. In contrast to intrapleural alteplase administration for other indications such as empyema, higher doses and volumes of alteplase are recommended for retained hemothorax.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute imaging for evidence-based treatment of ischemic stroke. (Pubmed Central) - Apr 22, 2020
In contrast to intrapleural alteplase administration for other indications such as empyema, higher doses and volumes of alteplase are recommended for retained hemothorax. In stroke patients with unknown symptom onset or known symptom onset up to 24 h, advanced imaging with MRI or with CT perfusion can guide effective acute reperfusion treatment with mechanical thrombectomy and intravenous alteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Incidence and Risk Factors of Postcontrast Acute Kidney Injury in Patients with Acute Ischemic Stroke. (Pubmed Central) - Apr 21, 2020
We conducted a retrospective review of Thai acute ischemic stroke patients admitted to the King Chulalongkorn Memorial Hospital between January 2014 and December 2017 who received multimodal CT and thrombolytic treatment with alteplase...Two factors were associated with PC-AKI, eGFR ≤ 30 mL/min and mechanical thrombectomy. Patients without these risk factors may not need to wait for the results of renal function testing prior to multimodal CT.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Evaluation of Rescue Thrombolysis in Cardiac Arrest Secondary to Suspected or Confirmed Pulmonary Embolism. (Pubmed Central) - Apr 16, 2020
This retrospective review included adults who received alteplase or tenecteplase during cardiac arrest for suspected or confirmed PE...Conclusion and Relevance: Medical advances in PE management continue to evolve; yet the role of thrombolytic therapy in PE-related cardiac arrest remains unclear, with low overall rates of survival. These findings add to the relatively small body of evidence and highlight that optimal dosing remains unknown in this setting.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Innovations in Care Delivery of Stroke from Emergency Medical Services to the Neurointerventional Operating Room. (Pubmed Central) - Apr 15, 2020
The Neuro ED acts as our hub for EMS communication, imaging, administration of intravenous alteplase, and transition to the Neurointerventional OR. Our structure with its enabling of shortened IV alteplase delivery times and faster door-to-needle (DTN) times may serve as an international model for stroke centers.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Quantitative Signal Intensity in Fluid-Attenuated Inversion Recovery and Treatment Effect in the WAKE-UP Trial. (Pubmed Central) - Apr 15, 2020
In the randomized controlled WAKE-UP trial (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke Trial), intravenous alteplase was effective in patients with unknown onset stroke selected by visual assessment of diffusion weighted imaging fluid-attenuated inversion recovery mismatch, that is, in those with no marked fluid-attenuated inversion recovery hyperintensity in the region of the acute diffusion weighted imaging lesion...Conclusions- In patients in whom no marked parenchymal fluid-attenuated inversion recovery hyperintensity was detected by visual judgement in the WAKE-UP trial, higher FLAIR-rSI of diffusion weighted imaging lesions was associated with decreased treatment effects of intravenous thrombolysis. This parallels the known association of treatment effect and elapsing time of stroke onset.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: HaNDL is transient headache, neurological deficits and lymphocytic pleocytosis in the cerebrospinal fluid (Pubmed Central) - Apr 10, 2020
This is a case report of a 31-year-old woman, who experienced acute neurological deficits and was treated with IV alteplase on suspicion of acute ischaemic stroke...Every clinician working in acute neurology should have knowledge of this syndrome. Increased knowledge will help to diagnose and to differentiate from other potentially more harmful neurological states.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Predictors of malignant middle cerebral artery infarction after mechanical thrombectomy. (HoC Room) - Apr 9, 2020 - Abstract #EAN2020EAN_2221;
We selected patients from a prospective local database which reference all patients eligible for treatment with Alteplase thrombolysis and/or mechanical endovas- cular thrombectomy in acute stroke... Our study proposes a practical decision tree including DWI lesion volume and delay before recanalization to early and accurately predict MMI in a subgroup of patients with MCA infarction undergoing MET regardless to the status of reperfusion.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Don’t stop until you understand it - case series of Artery of Percheron infarction (Room: Screen B2) - Apr 9, 2020 - Abstract #EAN2020EAN_1128;
Neither was treated with intravenous alteplase... Strokes in the AOP territory should be considered in patients with nonlaterilizing neurological symptoms especially if MRI brain scan is not available and if the clincial features are not fully explained by the initial CT scan or the laboratory work-up.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Changes in the quality of care in Polish stroke units - the role of RES-Q registry (Room: Screen B1) - Apr 9, 2020 - Abstract #EAN2020EAN_1117;
Polish stroke units reporting cases to RES-Q in years 2017-2019 significantly improved their perfor- mance, including door-to-needle time and early dysphagia screening. It confirms that regular involvement in this quality oriented project may drive improvement, even in centres with high baseline standards of care.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Extending intravenous thrombolysis time window guided by CT Perfusion (Room Berlin) - Apr 9, 2020 - Abstract #EAN2020EAN_812;
Time onset of symptoms to the beginning of alteplase was 319min (range 280-510)... In our experience, selecting patients for IVT beyond 4.5 hours guided by CT perfusion is safe and effective, and is asociated with a good neurological prognosis at 3 months.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Thrombus Migration Paradox in Patients With Acute Ischemic Stroke. (Pubmed Central) - Apr 1, 2020
Administration of intravenous alteplase increases the chance of thrombus migration and resolution. Thrombus migration is associated with better functional outcome but reduces the rate of complete reperfusion.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Thrombolytic Therapy in Cocaine Users with Ischemic Stroke: A Review of Current Practice. (Pubmed Central) - Mar 31, 2020
The most common serious adverse reaction related to alteplase is the development of spontaneous intracerebral hemorrhage and the presence of cerebral small vessel disease may increase this risk, particularly in cocaine users, even if only few data have been published on this topic. Here we reviewed in cocaine users with acute ischemic stroke the efficacy and safety of thrombolytic therapy.
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