- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Experience with Mechanical Thrombectomy in Ischemic Stroke (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_6913;
Of these, 19.7% underwent thrombolysis with intravenous alteplase...CONCLUSIONS Our study showed results of efficacy and safety of mechanical thrombectomy in acute stroke. In addition, we found no direct relationship between Cerebral Hemorrhage and time from onset of symptoms to onset of procedure.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Inravenous Alteplase for Massive Pulmonary Embolus in a Patient with Sub Arachnoid Hemorrhage: A Case Report (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_6795;
CASE Intravenous Alteplase is contraindicated with a history of intracranial hemorrhage. To the best of our knowledge, this represents the first case ever reported where a patient received full dose (100 mg) of intravenous Alteplase twice within a 24 hour period for massive pulmonary embolism in the setting of an active subarachnoid hemorrhage with no neurologic complications and a stable neurologic exam at discharge.
- |||||||||| meropenem / Generic mfg., Daewon Pharmaceutical
Acute Pulmonary Embolism Unmasking Chronic Thromboembolic Pulmonary Hypertension, Leading to Infraction, Lung Abscess and Empyema (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_6742;
Low molecular weight heparin, meropenem and linezolid were also administered...The diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) was confirmed, and the patient was treated with riociguat.DiscussionWe presented a rare case of acute pulmonary embolism in the context of newly diagnosed CTEPH, leading to pulmonary infraction, cavitation, lung abscess and empyema...Our patient improved significantly after thoracotomy and surgical resection of lung abscess.ConclusionAcute pulmonary embolism might result in infraction formation and subsequent lung abscess and empyema in predisposed subjects. An unrecognised diagnosis of CTEPH might complicate the clinical course of these patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Functional Outcome Following Stroke Thrombectomy in Clinical Practice. (Pubmed Central) - Mar 13, 2020
P=N/A
Intravenous alteplase before endovascular treatment was given in 1457 patients (56%)...Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT03356392.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Trial completion date, Trial primary completion date: BETULA: Low Dose Catheter Directed Thrombolysis for Acute Pulmonary Embolism (clinicaltrials.gov) - Mar 12, 2020
P2, N=60, Recruiting,
No abstract available Not yet recruiting --> Recruiting | Trial completion date: Jan 2022 --> Mar 2024 | Trial primary completion date: Apr 2021 --> Mar 2023
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Patterns and Outcomes of Endovascular Therapy in Mild Stroke. (Pubmed Central) - Mar 10, 2020
Compared with NIHSS >5, those with NIHSS ≤5 arrived later to the hospital (median, 138 versus 101 minutes), were less likely to receive intravenous alteplase (30% versus 43%), had a longer door-to-puncture time (median, 167 versus 115 minutes) and more likely treated in South Florida (64% versus 53%)...Individual, hospital and geographic disparities are observed among endovascularly treated patients based on the severity of clinical symptoms. Our data suggest safety and overall favorable outcomes for EVT patients with mild stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Evidence that Tenecteplase Is Noninferior to Alteplase for Acute Ischemic Stroke. (Pubmed Central) - Mar 10, 2020
For safety end points, lower event rates reduced power, but point estimates were also consistent with noninferiority Conclusions- Accumulated clinical trial data provides strong evidence that TNK is noninferior to ALT in the treatment of acute ischemic stroke. These findings provide formal support for the recent guideline recommendation to consider TNK an alternative to ALT.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Time Extended for Use of Image-Guided Intravenous Alteplase After Stroke. (Pubmed Central) - Mar 10, 2020
These findings provide formal support for the recent guideline recommendation to consider TNK an alternative to ALT. Patients benefit from treatment up to nine hours.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Endovascular Thrombectomy for Stroke Effectiveness Study-An Audit From a Small Tertiary Care Center. (Pubmed Central) - Mar 10, 2020
A majority (72%) also received intravenous alteplase...At 90 days, 48% (36/75) were functionally independent (mRS score of 0-2) and 28% (21/75) were disabled (mRS score of 3-5); 24% (18/75) died (mRS of 6) within 90 days. An audit of our initial experience with EVT for the treatment of acute ischemic stroke in a small tertiary care center yielded similar results compared to the ESCAPE trial, which is encouraging for implementing this treatment in routine clinical practice.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Impact of prehospital stroke code in a public center in Paraguay: A pilot study. (Pubmed Central) - Mar 2, 2020
Prehospital stroke code patients had a lower mean door-to-CT time (24 vs. 33 min, p = 0.021) and lower mean door-to-needle time (35.3 vs.76.3 min, p < 0.001) compared to in-hospital stroke code patients. Prehospital stroke code is feasible in Paraguay and has a positive impact on in-hospital acute stroke management, reducing delays and increasing the rates of reperfusion treatments.
- |||||||||| aspirin / Generic mfg., clopidogrel / Generic mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Antiplatelet vs. R-tPA for acute mild ischemic stroke: A prospective, random, and open label multi-center study. (Pubmed Central) - Mar 2, 2020
The subjects are randomized to the control arm (intravenous alteplase with standard dose of 0.9 mg/kg, followed by guideline-based treatment 24 h after thrombolysis) or the experiment arm (clopidogrel: loading dose of 300 mg on the first day, followed by 75 mg daily for 10-14 days; aspirin: 100 mg on the first day, followed by 100 mg daily for 10-14 days; after the combination, antiplatelet will be given based on guideline till 90 days). The primary efficacy endpoint is favorable functional outcome, defined as a mRS 0-1 assessed at 90-day post-randomization.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Review, Journal: Interventions for Occluded Central Venous Catheters: A Meta-analysis. (Pubmed Central) - Feb 28, 2020
The primary efficacy endpoint is favorable functional outcome, defined as a mRS 0-1 assessed at 90-day post-randomization. On the basis of the evidence obtained, thrombolysis is effective and potentially safe in this population.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial. (Pubmed Central) - Feb 25, 2020
The distribution of the modified Rankin Scale scores 90 days after stroke also showed a nonsignificant shift toward better outcomes in patients with lacunar infarcts treated with alteplase, with an adjusted common odds ratio of 1.94 (95% CI, 0.95-3.93). While the WAKE-UP trial was not powered to demonstrate the efficacy of treatment in subgroups of patients, the results indicate that the association of intravenous alteplase with functional outcome does not differ in patients with imaging-defined lacunar infarcts compared with those experiencing other stroke subtypes.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute Management of Ischemic Stroke During Pregnancy. (Pubmed Central) - Feb 24, 2020
Patients presenting within 4.5 hours of symptom onset and with an initial normal head CT scan are candidates for alteplase (tissue plasminogen activator [tPA])...Antiplatelet agents are indicated for secondary prevention. The management of cerebral venous sinus thrombosis, carotid and vertebral dissections, and reversible cerebral vasoconstrictive disease should overall follow same guidelines as for nonpregnant individuals.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Intravenous thrombolysis after reversion of acenocoumarol anticoagulation. Report of one case (Pubmed Central) - Feb 23, 2020
Neuroimaging was compatible with an acute middle cerebral artery ischemic stroke. Anticoagulation was reverted with the use of four factor prothrombin complex, followed by thrombolysis with alteplase, with a favorable evolution, returning to his basal functional status.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Association of Early Oxygenation Levels with Mortality in Acute Ischemic Stroke - A Retrospective Cohort Study. (Pubmed Central) - Feb 21, 2020
In this retrospective cohort study, we are reporting a strong association between lower SpO/FiO levels in the first few hours of admission and mortality. In the light of these results, we plan to prospectively assess the role of oxygenation further in the context of recanalization status of stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Redefining Early Neurological Improvement After Reperfusion Therapy in Stroke. (Pubmed Central) - Feb 21, 2020
Percentage change in NIHSS score may be a better surrogate marker of ENI and functional outcome in AIS patients after receiving acute thrombolytic therapy. More studies are needed to confirm our findings.
- |||||||||| Pulmozyme (dornase alfa) / Roche, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Enrollment change: Fibrinolytic Therapy Versus Medical Thoracoscopy (clinicaltrials.gov) - Feb 20, 2020
P4, N=5, Completed,
A larger proportion of LEP patients were treated with IVTwith the use of a VSS triage tool, and there were trendstowards lower DTT and DTN times. Recruiting --> Completed | N=70 --> 5
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: The use of alteplase in a newborn with an aortic arch thrombus during extracorporeal membrane oxygenation. (Pubmed Central) - Feb 20, 2020
Alteplase was successfully administered to this neonate after the repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation, and the patient survived without apparent catastrophic long-term complications. It is reasonable to consider alteplase therapy during extracorporeal membrane oxygenation support in this setting.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Review, Journal: Tenecteplase versus alteplase in acute ischemic stroke: systematic review and meta-analysis. (Pubmed Central) - Feb 14, 2020
Other outcomes did not differ between the tenecteplase and alteplase groups. Trials of cost-effective/benefit analysis comparing tenecteplase versus alteplase and tenecteplase versus endovascular treatment are necessary to reinforce the evidence for the potential cost advantage of tenecteplase.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Safety and predictors of stroke mimics in The Norwegian Tenecteplase Stroke Trial (NOR-TEST). (Pubmed Central) - Feb 14, 2020
Conclusion Thrombolysis with tenecteplase seems to be as safe as with alteplase in stroke mimics. Predictors were identified for stroke mimics which may contribute to differentiate stroke mimics from acute cerebral ischemia in future stroke trials.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Statistical analysis plan for evaluating different intensities of blood pressure control in the ENhanced Control of Hypertension And Thrombolysis strokE stuDy. (Pubmed Central) - Feb 14, 2020
P3, P4
The ENhanced Control of Hypertension And Thrombolysis strokE study (ENCHANTED) trial was initiated as a 2 × 2 partial-factorial active-comparison, prospective, randomized, open, blinded endpoint clinical trial to evaluate in thrombolysis-eligible acute ischemic stroke (AIS) patients whether: (1) Arm A - low-dose (0.6 mg/kg body weight) intravenous (iv) alteplase has noninferior efficacy and lower risk of symptomatic intracerebral hemorrhage (sICH) compared with standard-dose (0.9 mg/kg body weight) iv alteplase; and (2) Arm B - early intensive blood pressure (BP) lowering (systolic target 130-140 mmHg) has superior efficacy and lower risk of ICH compared with guideline-recommended BP control (systolic target <180 mmHg)...Conclusions We have developed a predetermined SAP for the ENCHANTED BP control arm to be followed to avoid analysis bias arising from prior knowledge of the study findings. Clinical trial registration ClinicalTrials.gov (NCT01422616); ISRCTN Register (ISRCTN82387104); Australian New Zealand Clinical Trial Registry (ACTRN12611000236998); EU Clinical Trials Register (2011-005545-12); and Clinical Trials Registry - India (REF/2017/05/014334).
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute stroke treatment in old age (Pubmed Central) - Feb 14, 2020
Patients over 80 years often do not undergo IVT or MT. Although the German approval for alteplase within the framework of IVT over the age of 80 years suggests a careful and critical review of the indications, its use is generally recommended.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Neurological Complications of Cardiac Tumors. (Pubmed Central) - Feb 9, 2020
Clinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile...Hyperacute stroke treatment seems to be safe, and mechanical thrombectomy is a reasonable treatment. A conservative approach towards myxomatous aneurysms should be considered.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Stroke in malignancy: complexities of diagnosis and management: a case report. (Pubmed Central) - Feb 7, 2020
A conservative approach towards myxomatous aneurysms should be considered. This case highlights the importance of having a high threshold of suspicion for malignancy as a cause of stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke. (Pubmed Central) - Feb 7, 2020
Rapid administration of alteplase was not associated with significantly better outcomes nor increased risk of ICH. Conclusions about efficacy are limited due to the retrospective nature of the study, small sample size, and incomplete data points.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Alcohol Intoxication as a Stroke Mimic and the Incidence of Acute Alcohol Intoxication in Stroke. (Pubmed Central) - Feb 7, 2020
Acute alcohol intoxication as sole diagnosis was diagnosed in 1% of the total cohort and 7% of stroke mimics, 50% denied or downplayed their alcohol consumption. 5% of all stroke patients also drank alcohol, they were significantly less likely to receive alteplase or endovascular treatment.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Intrapleural alteplase therapy: what are the knowns and unknowns? (Pubmed Central) - Feb 7, 2020
Although the first intrapleural administration of fibrinolytic occurred seventy years ago, there has been no consensus on dosing or a uniform procedure of their application. The aim of the article is to summarize current knowledge of alteplase usage in pneumology and discuss practical aspects of its intrapleural application regarding specific possibilities in the Czech Republic.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion: TOPCAT: t-PA Prophylaxis to Prevent Catheter-associated Thrombosis and Infection (clinicaltrials.gov) - Jan 30, 2020
P2, N=20, Completed,
The aim of the article is to summarize current knowledge of alteplase usage in pneumology and discuss practical aspects of its intrapleural application regarding specific possibilities in the Czech Republic. Recruiting --> Completed
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Choosing the Correct "-ase" in Acute Ischemic Stroke: Alteplase, Tenecteplase, and Reteplase. (Pubmed Central) - Jan 28, 2020
Primary factors contributing to medication errors include use of the abbreviations "TPA," "tPA," or "TNK" in written or verbal orders and use of these agents in similar settings. Steps to reduce the likelihood of accidental substitution include use of full brand or generic names and inclusion of the indication in written and verbal orders, addition of alerts in automated dispensing machines and ordering systems, and use of stroke boxes containing alteplase and materials for administration.
|
