- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
A Nurse Driven Acute Stroke Alert Process Improves Treatment Times and Treatment Rates (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1429;
The sICH rate was reduced from Period A to C, meaning that increased treatment rate did not lead to increased hemorrhagic rate. Nursing initiatives can have a substantial positive effect on increasing the number of patients treated with IV alteplase for acute ischemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Asymptomatic Hemorrhage Predicts Delayed Symptomatic Hemorrhage After Alteplase in Acute Ischemic Stroke (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1411;
Delaying initiation of antithrombotic treatment in patients with asymptomatic hemorrhage on 24 hour imaging was not associated with reduced delayed sICH risk. It is possible that other factors such as reperfusion and blood brain barrier disruption are more important determinants of delayed sICH risk as opposed to timing of antithrombotic therapy initiation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Maryland Stroke Coalition: Six Year Coordinated Cooperative Approach Improves Thrombolytic Performance (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1355;
The MSC’s coordinated cooperative approach to performance improvement was associated with increased IV Alteplase administration rates and decreased median door to IV Alteplase administration times. The MSC's leadership plan is to perform a statewide cultural assessment to identify barriers and facilitators to assist stroke centers increase the percentage of patients who receive alteplase < 45 minutes and to improve door in-door out times for mechanical thrombectomy patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Validation of the Fast-ed Scale Use by Paramedics in a Mobile Stroke Unit (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1337;
28 (14%) patients received intravenous alteplase... The correlation of the FAST-ED scoring between vascular neurologists and paramedics was highly positive, indicating that FAST-ED is accurately and reliably utilized by paramedics in the pre-hospital setting.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Feasibility of a Large-Scale Teleneurology Network for Thrombolysis Administration in a Heterogeneous Multihospital Population (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1294;
BACKGROUND Administration of alteplase is the standard of care for eligible patients presenting with symptoms of acute ischemic stroke (AIS)...CONCLUSION A large-scale teleneurology platform for the emergent treatment of patients presenting with AIS symptoms is both safe and feasible. Due to the heterogeneity of this patient and hospital population, higher level refinement of this analysis to include hyperacute metrics, transfer data, and more comprehensive clinical and functional outcomes is warranted.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
The Multiple-Encounter Multiply-Thrombolysed Telestroke Patient - A Unique Patient Population (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1280;
CONCLUSION The observed phenomena of recurrent teleneurology encounters for patients presenting with suspected AIS symptoms and receiving alteplase at increased rates is not well-described and is poorly understood. Given the inherent risk and resource utilization associated with thrombolysis, further analysis of the characteristics of this patient population is warranted.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Pharmacists Improve Door to Needle Times in the Emergency Department (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1278;
Presence of a pharmacist in the ED enabled fast and safe delivery of alteplase by ensuring accurate dosing and preparation. Pharmacists also performed rapid medication reconciliation and expedited antihypertensive therapies.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Predictors and Outcomes of Successful First Pass in Neurothrombectomy- Insights From the STAR Collaboration (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1211;
The use of Solumbra technique was an independent predictor of SFP (OR 1.2, 95% CI 1.1-1.4, P=0.004) after controlling for age, sex, location of occlusion, National Institute of Health stroke scale (NIHSS) on presentation, intravenous alteplase (IV-tPA), and onset to groin (OTG) time...Conclusion : SFP lead to higher rates of functional independence in stroke patients with large vessel occlusion. These records reiterate the importance of SFP as a benchmark measure for stroke thrombectomy devices.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
The Reality of Acute Stroke Care at a Public Hospital in Northeast Brazil (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_1191;
Conclusion : The data show that it is necessary to implement a public policy for stroke care in this region of Brazil, including training of professionals and implementation of new acute care centers. This, along with increasing awareness among the population and devoting further attention to stroke post-treatment, can ensure universality, equity and comprehensiveness of stroke treatment in this region of Brazil and elsewhere.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Time to Alteplase and Symptomatic Intracranial Hemorrhage Complication Rates (Room 515 B) - Dec 21, 2019 - Abstract #ISC2020ISC_1149;
Interestingly, a reduction in door-to-needle times was associated with a reduction in complication rates. This supports the American Heart Association’s new Target Stroke Phase III initiative which seeks to further reduce door-to-needle times.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Reperfusion Improves Clinical Outcome Across the 4.5-9h and Wake-Up Stroke Time Continuum in EXTEND and EPITHET (Room 502 A) - Dec 21, 2019 - Abstract #ISC2020ISC_1029;
These data highlight opportunities to improve inpatient systems of stroke care further. Strong benefits of reperfusion in all time strata without differential risk in symptomatic hemorrhage support the durable treatment effect of alteplase in perfusion mismatch-selected patients throughout the 4.5-9h and wake-up stroke time window.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
CT Perfusion Imaging in Telestroke Can Assist With Decision Making Without Delaying IV Alteplase (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_771;
Final results of the NAS-Care study will be presented at the International Stroke Conference. In conclusion, automated perfusion maps and calculated ischemic penumbra size in CTP allowed telestroke physicians to make quicker transfer decisions, without delaying DTN.
- |||||||||| aspirin / Generic mfg., warfarin / Generic mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Asian versus Non-Asian, Differences in Characteristics, Management & Outcomes in the Enchanted Trial (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_718;
Among 4562 patients (mean age 66.6 years, 37.8% female, 65.5% Asian) Asian patients were younger and less likely to have atrial fibrillation and hypercholesterolemia and taking fewer antihypertensive, warfarin, aspirin and statin therapy compared to non-Asians... Compared to non-Asians, Asian patients were at increased risk of ICH and residual disability after thrombolysis treatment for AIS, suggesting the need to access more evidence-based care in acute management.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Contemporary Use of IV Alteplase in Acute Ischemic Stroke Beyond 4.5 Hours of Stroke Onset in Clinical Practice is Rare (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_717;
The use of IV tPA at >4.5 h from LKW as a proportion of all tPA cases treated varied substantially across sites (median (IQR) 1.7% (0-3.1%)) but fewer than ~10% of sites had more than 5% of their tPA use occurring beyond 4.5 h. Compared to 4.5 h differed in age, AF, arrival mode/time, stroke severity and hospital region (Table). Conclusions During the past decade and prior to published RCT evidence that extended window IV tPA was effective, US sites in GWTG-Stroke rarely treated patients beyond the guideline-approved window of 4.5 h. It will be important to monitor adoption of extended window thrombolysis in the US, and determine if additional RCT data are required to change practice.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_716;
Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Alteplase Now: Benefits of IV tPA in Lacunar Stroke, LVO, pAF, and Minor or Resolving Stroke (Room 151) - Dec 21, 2019 - Abstract #ISC2020ISC_487;
Less than half of patients with mild strokes recanalized with IV alteplase which was associated with longer decision-making times suggesting that more aggressive use of thrombolytics and/or EVT may be viable treatment options in this population. There is no abstract associated with this presentation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
ESCAPE-NA1 Trial (Hall K) - Dec 21, 2019 - Abstract #ISC2020ISC_313;
ESCAPE NA-1 was a pivotal, global phase 3 trial, of a novel peptide treatment for acute ischemic stroke using the paradigm of human ischemia reperfusion. Results are expected to provide an understanding of the initial role of the neuroprotectant nerinetide (NA-1) in AIS.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Hemifacial angioedema following alteplase for acute stroke. (Pubmed Central) - Dec 20, 2019
The optimal TNK dose for ischemic stroke patients appears to be 0.25mg/kg. No abstract available
- |||||||||| Aggrastat (tirofiban) / Correvio, Medicure, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: Tirofiban for Patients Treated With Alteplase (clinicaltrials.gov) - Dec 17, 2019
P2/3, N=220, Recruiting,
No abstract available Trial completion date: Mar 2019 --> Oct 2020 | Trial primary completion date: Dec 2018 --> Jun 2020
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Trial primary completion date: INTRECIS: Intravenous Thrombolysis Registry for Chinese Ischemic Stroke Within 4.5 h Onset (clinicaltrials.gov) - Dec 17, 2019
P=N/A, N=4000, Completed,
Trial completion date: Mar 2019 --> Oct 2020 | Trial primary completion date: Dec 2018 --> Jun 2020 Active, not recruiting --> Completed | Trial primary completion date: Apr 2019 --> Oct 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Single-center experience with thrombolysis in high- and intermediaterisk pulmonary embolism (Industry Exhibition/Foyer) - Dec 17, 2019 - Abstract #GTH2020GTH_150;
The risk of relevant bleedings in patients at intermediate risk receiving thrombolysis was relatively low - possibly because half of them received low-dose alteplase or local lysis. According to current guideline recommendations, the choice for thrombolysis in intermediate-risk PE patients needs to take into account each individual patient's risk for bleeding and PE-related death and these data reinforce this approach.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Retrospective data, Journal: Current Smoking Does Not Modify the Treatment Effect of Intravenous Thrombolysis in Acute Ischemic Stroke Patients-A Post-hoc Analysis of the WAKE-UP Trial. (Pubmed Central) - Dec 12, 2019
P3
We performed a pre-specified post-hoc subgroup analysis of the Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke (WAKE-UP) trial that randomized AIS patients with unknown time of symptom onset who had diffusion-weighted imaging-fluid attenuation inversion recovery (DWI-FLAIR) mismatch to either alteplase or placebo...Clinical Trial registration: Main trial (WAKE-UP): ClinicalTrials.gov, NCT01525290; and EudraCT, 2011-005906-32. Registered 02 February 2012.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Trial initiation date: AcTQuICR: Alteplase Compared to Tenecteplase in Patients With Acute Ischemic Stroke (clinicaltrials.gov) - Dec 12, 2019
P3, N=1600, Recruiting,
Registered 02 February 2012. Not yet recruiting --> Recruiting | Initiation date: Jun 2019 --> Dec 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Minimally Invasive Subacute to Chronic Subdural Hematoma Evacuation with Angled Matchstick Drill and Repurposed Antibiotic Ventriculostomy Catheter Augmented with Alteplase: A Technical Case Report. (Pubmed Central) - Dec 12, 2019
The operative management of subacute subdural hematomas (sSDHs) and chronic subdural hematomas (cSDHs) in the elderly is complicated by age itself, multiple medical comorbidities, and anticoagulant and antiplatelet medications; therefore, the search for less invasive, yet more effective, treatment techniques has become a goal. Here, we present the use of a repurposed ventriculostomy catheter in the minimally invasive drainage of a mixed sSDH with the residual solid clot component subsequently liquefied with local alteplase (tPA) administration in an elderly female producing effective hematoma and symptom resolution.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Biomarker, Clinical, Journal: Factors predicting the outcome of intravenous thrombolysis in stroke patients before rt-PA administration. (Pubmed Central) - Dec 10, 2019
We enrolled 118 ischemic stroke patients who were treated with standard dose of Alteplase in our hospital...Significant predictors for outcome at 3 months according to multivariable regression analysis were NIHSS score (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.498-0.750; p<0.001), SBP (OR, 0.95; 95% CI, 0.925-0.991; P=0.01), AF (OR, 0.09; 95% CI, 0.013- 0.708; P=0.02), CAD (OR, 17.08; 95% CI, 0.013-0.708; p=0.003). Higher NIHSS score, higher SBP on admission, AF and history of CAD could be the independent predictors of outcome after IVT in acute ischemic stroke patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Neuroimaging selection for thrombectomy in pediatric stroke: a single-center experience. (Pubmed Central) - Nov 29, 2019
Perfusion imaging is feasible in pediatric stroke and may help identify salvageable tissue in extended time windows, though penumbral thresholds may differ from adult values. Further studies are needed to define criteria for thrombectomy in this unique population.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Status of prehospital delay and intravenous thrombolysis in the management of acute ischemic stroke in Nepal. (Pubmed Central) - Nov 23, 2019
Conclusions- Faster intravenous thrombolysis delivery is associated with less disability at 3 months among patients with large vessel occlusion. Community-based intervention to spread awareness, establishing comprehensive stroke centers, training specialists, improving emergency services, establishment of telestroke facilities and encouraging the use of low-cost tenecteplase as an alternative to alteplase can help improve care for stroke patients in Nepal.
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