- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Bacterial staphylokinase as a promising third-generation drug in the treatment for vascular occlusion. (Pubmed Central) - Jun 14, 2020
Despite the potent clot lysis achievable using approved thrombolytic drugs such as alteplase, reteplase, streptokinase, tenecteplase, and some other fibrinolytic agents, there are some drawbacks, such as high production cost, systemic bleeding, intracranial hemorrhage, vessel re-occlusion by platelet-rich and retracted secondary clots, and non-fibrin specificity...A fibrin-bound plasmin-staphylokinase complex shows high resistance to a-antiplasmin-related inhibition. Staphylokinase has the potential to be considered as a promising thrombolytic agent with properties of cost-effective production and the least side effects.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine. (Pubmed Central) - Jun 13, 2020
This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM. Hemiplegic migraine (HM) is difficult to diagnose and can mimic stroke, resulting in administration of dangerous medications such as thrombolytics/alteplase.A thorough history, intercommunication between health systems and integrated EMR are essential for early diagnosis and management of HM.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Successful Intravenous Alteplase for a Centenarian Woman with Acute Ischaemic Stroke. (Pubmed Central) - Jun 12, 2020
There are no data on what is the best method to use to manage centenarians. Our successful thrombolysis case indicates that biologically young centenarians may profit from thrombolysis, despite the very high age.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Identifying stroke therapeutics from preclinical models: A protocol for a novel application of network meta-analysis. (Pubmed Central) - Jun 12, 2020
This protocol details planned methods to conduct a systematic review to identify and appraise eligible studies and to use a network meta-analysis to synthesize available evidence to answer the following questions: in preclinical in vivo models of focal ischemic stroke, what are the relative benefits of competing therapies tested in combination with the gold standard treatment alteplase in (i) reducing cerebral infarction size, and (ii) improving neurobehavioural outcomes?...Combining all evidence to simultaneously compare mutliple therapuetics tested preclinically may provide a rationale for the clinical translation of therapeutics for patients with ischemic stroke. Dissemination: Review findings will be submitted to a peer-reviewed journal and presented at relevant scientific meetings to promote knowledge transfer. Registration: PROSPERO number to be submitted following peer review.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, P3 data, Journal: Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial. (Pubmed Central) - Jun 8, 2020
P3
Sonothrombolysis delivered by an operator-independent device to patients treated with alteplase after acute ischaemic stroke was feasible and most likely safe, but no clinical benefit was seen at 90 days. Sonothrombolysis could be further investigated either in randomised trials undertaken in stroke centres that are dependent on patient transfer for endovascular reperfusion therapies or in countries where these treatments cannot yet be offered as the standard of care.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke. (Pubmed Central) - Jun 8, 2020
P=N/A
In Chinese patients with acute ischemic stroke from large-vessel occlusion, endovascular thrombectomy alone was noninferior with regard to functional outcome, within a 20% margin of confidence, to endovascular thrombectomy preceded by intravenous alteplase administered within 4.5 hours after symptom onset. (Funded by the Stroke Prevention Project of the National Health Commission of the People's Republic of China and the Wu Jieping Medical Foundation; DIRECT-MT ClinicalTrials.gov number, NCT03469206.).
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Recent advances in spontaneous intracerebral hemorrhage. (Pubmed Central) - Jun 5, 2020
The purpose of this review is to provide an update on important research on ICH over the past three years. Topics covered include risk factors, imaging predictors of hematoma expansion, scoring schema to predict hematoma expansion, hemostatic therapies, acute blood pressure lowering, intraventricular administration of alteplase for intraventricular hemorrhage, and the current status of surgical therapies.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design. (Pubmed Central) - Jun 4, 2020
Topics covered include risk factors, imaging predictors of hematoma expansion, scoring schema to predict hematoma expansion, hemostatic therapies, acute blood pressure lowering, intraventricular administration of alteplase for intraventricular hemorrhage, and the current status of surgical therapies. MaRISS will define outcomes and their predictors and clarify the effects of alteplase in patients with mild and rapidly improving stroke symptoms, providing clinicians with important information to manage this population.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke. (Pubmed Central) - May 31, 2020
With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to 3...This case highlights the importance of magnetic resonance imaging in diagnosing pediatric acute ischemic stroke and suggests consideration of thrombolysis in select confirmed pediatric stroke cases. However, a rigorous evidence base is lacking, and clinical trials have not been successful in recruiting patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Pump Thrombosis, Scratching the Surface. (Pubmed Central) - May 30, 2020
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
Journal: Hybrid Thrombolysis for Left Ventricular Assist Device Thrombosis. (Pubmed Central) - May 30, 2020
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
Clinical, Journal: Angioedema Associated With Thrombolysis For Ischemic Stroke: Analysis Of A Case-Control Study. (Pubmed Central) - May 26, 2020
In OHCA patients with confirmed PE and admitted with recuperation of spontaneous circulation in the hospital, there was significantly higher 30-day survival in those who received thrombolysis during CPR compared with patients who did not receive thrombolysis. This case-control study points out angiotensin-converting enzyme inhibitors and female sex as risk factors of bradykinin-angioedema associated with thrombolysis for ischemic stroke.
- |||||||||| Pulmozyme (dornase alfa) / Roche, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: The first use of combination of Intrapleural Fibrinolytics (Alteplase & DNAse) for pleural infection in Malaysia. (Pubmed Central) - May 25, 2020
Its efficacy and success rate in selected cases of complicated parapneumonic effusion unresponsive to antibiotics and chest drainage are well documented. This case report demonstrates the first use of combination intrapleural fibrinolytic (Alteplase) and DNAse (Pulmozyme) in Malaysia for a case of pleural infection/parapneumonic effusion.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] The reality of the acute treatment for ischemic stroke in a Brazilian reference hospital () - May 24, 2020 - Abstract #EAN2020EAN_3639;
Introduction: The use of endovenous alteplase in the acute treatment of ischemic stroke (IS) is well established (NINDS, 1995; ECASS, 1995-2008) regarding an endovenous treatment in the therapeutic window of 4.5 hours since the begging of the ischemic symptoms... In the most majority of the cases, the time interval between the ictus and the first neurological evaluation was too long for an adequate acute endovenous treatment of the ischemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Is thrombolytic treatment with Tenecteplase a new trend in the man- agement of the acute phase of ischemic stroke? () - May 24, 2020 - Abstract #EAN2020EAN_3626;
In the most majority of the cases, the time interval between the ictus and the first neurological evaluation was too long for an adequate acute endovenous treatment of the ischemic stroke. 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.
- |||||||||| 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.
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