- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Evaluation of a Hospital Pharmacist Annual Competency Program. (Pubmed Central) - Sep 27, 2019
The competency assessment program led to improvements in pharmacist self-efficacy in dealing with low-volume, high-risk clinical pharmacy tasks. Future studies could assess various forms of competency assessment and timing of these programs to determine the most effective way to ensure pharmacist competency.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
First in human clinical trial of robot-assisted subretinal drug delivery under local anaesthesia (Room 241 (Level 2)) - Sep 26, 2019 - Abstract #EURETINA2019EURETINA_1484;
P=N/A
After standard vitrectomy, intraoperative OCT-guided (Zeiss Resight 7000) subretinal injection of recombinant tissue plasminogen activator (rt-PA, Alteplase, Boehringer-Ingelheim, Germany) was performed either by robot-assisted or conventional manual technique... This first in human study demonstrates the feasibility and safety of high precision robot-assisted subretinal drug delivery under local anaesthesia, simulating its potential future application in subretinal gene or cell therapy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Biomarker, Journal: Identification of Corticospinal Tract Lesion for Predicting Outcome in Small Perfusion Stroke. (Pubmed Central) - Sep 26, 2019
Alteplase treatment was an independent unfavorable factor for excellent outcome (alteplase-treated 72.0% versus untreated 83.5%; odds ratio, 0.541; P=0.025)...Conclusions- Only patients with CST hypoperfusion without CST infarction among eligible acute ischemic stroke patients with small perfusion lesions could benefit from thrombolysis, which needs to be confirmed in future prospective studies. Patient selection, including an assessment of lesion location rather than purely lesion volume, may be ideal.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
EXTRACORPOREAL CPR IN A PATIENT WITH FULMINANT PULMONARY EMBOLISM REFRACTORY TO INTRA-ARREST THROMBOLYSIS (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3494;
Patient selection, including an assessment of lesion location rather than purely lesion volume, may be ideal. Nineteen minutes after initiation of CPR, alteplase was administered despite which, return of spontaneous circulation (ROSC) could not be achieved...ECPR is a potentially life-saving therapeutic modality in patients with FPE who have failed intra-arrest thrombolytics.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
MASSIVE PULMONARY EMBOLISM IN PREGNANCY: A THERAPEUTIC CHALLENGE (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3453;
Additional considerations must be given to the fetus as well. The existing literature and guidelines could not be directly applied to this patient.
- |||||||||| warfarin / Generic Mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe, Eliquis (apixaban) / BMS
NEW RIGHT BUNDLE BRANCH BLOCK IN PATIENT WITH SUBMASSIVE PULMONARY EMBOLISM DURING CATHETER-DIRECTED THROMBOLYSIS (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3375;
RBBB presence only while catheterized suggests atrial stimulation as the cause and that this phenomenon could be seen in other cases. This transient RBBB due to catheter's impact on a patient's innate RV function needs to be studied further.
- |||||||||| Pulmozyme (dornase alfa) / Roche
NEAR FATAL HEMOMEDIASTINUM WITH HEMOPNEUMOTHORAX FOLLOWING ENDOBRONCHIAL ULTRASOUND-GUIDED BIOPSY (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 3) - Sep 25, 2019 - Abstract #CHEST2019CHEST_2724;
In this patient without thrombocytopenia, coagulopathy or hepatic dysfunction it was an unforeseen complication. This case represents the first reported case of EBUS-TBNA induced hemomediastinum and hemopneumothorax requiring additional VATS with decortication for symptomatic resolution.
- |||||||||| Leukeran (chlorambucil) / GSK, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
CONSIDERATIONS FOR CHYLOTHORAX IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 3) - Sep 25, 2019 - Abstract #CHEST2019CHEST_2590;
This case represents the first reported case of EBUS-TBNA induced hemomediastinum and hemopneumothorax requiring additional VATS with decortication for symptomatic resolution. Intrapleural alteplase and DNAse were instilled for 6 doses in attempt to reexpand the lung...Low fat diet, octreotide, chlorambucil and prednisone were initiated...High suspicion for chylothorax must be maintained in CLL patients with pleural effusion to avoid delaying directed intervention.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
EVALUATION OF PERI-ARREST THROMBOLYSIS SECONDARY TO CONFIRMED OR SUSPECTED PULMONARY EMBOLISM (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_2448;
A small portion of patients were found to have confirmed PE and PEA was the most common presenting rhythm. Furthermore, of the two patients that survived, different dosing strategies were observed, emphasizing the fact that optimal dosing is unknown.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
PROTOCOLIZED USE OF CATHETER-DIRECTED THROMBOLYSIS AND ECHOCARDIOGRAPHY IS HIGHLY EFFECTIVE IN REVERSING ACUTE RIGHT HEART DYSFUNCTION IN SEVERE SUBMASSIVE PULMONARY EMBOLISM PATIENTS (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 3) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1937;
Furthermore, of the two patients that survived, different dosing strategies were observed, emphasizing the fact that optimal dosing is unknown. Patients with severe right heart dysfunction (RV/LV≥ ratio 1.4) were protocolized to receive catheter directed thrombolysis via EkoSonic catheters (EKOS Corporation, Bothell, WA) in the pulmonary vasculature for thrombolysis with Alteplase (tPA) at 1 mg per hour total...This retrospective study demonstrates the effectiveness of protocolized use of catheter-directed thrombolysis and echocardiography in reversing severe right heart dysfunction in submassive pulmonary embolism patients.Clinical Implications:Protocolized use of Echocardiography with catheter-directed thrombolysis is effective at reversing severe right heart dysfunction in submissive pulmonary embolism patients without requiring repeat imaging studies or invasive follow up procedures.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
WHEN ONE PROBLEM ISN'T ENOUGH: PULMONARY EMBOLISM COMPLICATED BY MULTIPLE HEMORRHAGIC PHENOMENA (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1923;
We present a patient who developed numerous hemorrhagic complications after administration of alteplase, an analogue of tissue-plasminogen activator (tPA), in the setting of pulmonary embolism complicated by obstructive shock.Case Presentation:Our patient is a 63-year-old male with a history of untreated hypertension and alcohol use disorder...The lack of risk stratification tools makes the decision of mechanical versus chemical thrombus removal challenging. Further research is required to establish evidence-based management algorithms for patients with complicated pulmonary emboli.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
CATHETER DIRECTED THROMBOLYSIS IN SUBMASSIVE PULMONARY EMBOLISM: EXPERIENCE IN A COMMUNITY HOSPITAL SETTING (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 3) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1908;
Further research is required to establish evidence-based management algorithms for patients with complicated pulmonary emboli. Duration of alteplase (tPA) infusion ranged from 6 to 24 hours and the mean dose was 25 mg (range 16-34 mg)...This case series demonstrates that CDT may be a useful and safe modality for sPE when performed in a community hospital setting.Clinical Implications:sPE can be effectively managed by a multidisciplinary team in a community hospital setting utilizing catheter directed therapy.
- |||||||||| warfarin / Generic Mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
THE CLOT BEFORE THE STORM: PULMONARY EMBOLISM ASSOCIATED WITH LARGE THROMBUS IN TRANSIT TRAVERSING PFO (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1886;
Systemic thrombolytic therapy is the widely accepted treatment for high-risk PE but its use can be extended to intermediate-high risk PE with clot in transit. Further studies to validate the best method.
- |||||||||| piperacillin sodium/tazobactam sodium / Generic Mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
DENTAL INFECTION LEADING TO A PULMONARY CATASTROPHE IN AN IMMUNOCOMPETENT PATIENT (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1552;
Due to the aggressiveness of this conditions and high mortality rate, patient survival is dependent on an early recognition. Medical and surgical intervention with proper antimicrobial therapy has a cure of 90-95% after appropriate management.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Half-Dose Versus Full-Dose Alteplase for Treatment of Pulmonary Embolism. (Pubmed Central) - Sep 20, 2019
Treatment escalation occurred more often in half-dose-treated patients. These results question whether half-dose alteplase provides similar efficacy with improved safety, and highlights the need for further study before use of half-dose alteplase therapy can be routinely recommended in patients with pulmonary embolism.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Acute Treatment of Stroke (Except Thrombectomy). (Pubmed Central) - Sep 20, 2019
Further ongoing and future trials are eagerly awaited in this ever-expanding area. Although definitive trials have led to improvements in acute stroke care, there remains a need for further research to improve our understanding of pathophysiological mechanisms underlying different stroke types with the potential for treatments to be tailored to the individual.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Endovascular Thrombectomy for Mild Strokes: How Low Should We Go? (Pubmed Central) - Sep 20, 2019
Clinical outcomes were compared through a multivariable logistic regression after adjusting for age, presentation NIHSS, time last seen normal to presentation, center, IV alteplase, Alberta Stroke Program early computed tomographic score, and thrombus location...Conclusions- Our retrospective multicenter cohort study showed no improvement in excellent and independent functional outcomes in mild strokes (NIHSS, <6) receiving thrombectomy irrespective of thrombus location, with increased symptomatic intracerebral hemorrhage rates, consistent with the guidelines recommending the treatment for NIHSS ≥6. There was a signal toward benefit with EVT only in M1 occlusions; however, this needs to be further evaluated in future randomized control trials.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Volumetric and Spatial Accuracy of Computed Tomography Perfusion Estimated Ischemic Core Volume in Patients With Acute Ischemic Stroke. (Pubmed Central) - Sep 20, 2019
Methods- Patients from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) and EXTEND-IA TNK (Tenecteplase Versus Alteplase Before Endovascular Therapy for Ischemic Stroke) databases who had pretreatment CTP, >50% angiographic reperfusion, and follow-up magnetic resonance imaging at 24 hours were included...Volumetric CTP core overestimation was uncommon and not related to imaging-to-reperfusion time. Core overestimation in white matter should be a focus of future efforts to improve CTP accuracy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Optimization of Prehospital Triage of Patients With Suspected Ischemic Stroke. (Pubmed Central) - Sep 12, 2019
This model may be further refined by incorporating real-time data on traffic patterns and actual EVT and alteplase timeliness performance. Further studies are needed to verify model predictions.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
The “Stroke Code” model in a low-resources first-level Emergency Department. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_1673;
The stroke-code model can be successfully applied after a brief training period in a low-resources first-level ED in order to reduce DTN for acute ischaemic stroke treatment. In our experience the stroke-model performing was associated with a better functional outcome without any clinically relevant harm.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Right heart thrombi in pulmonary embolism. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_1650;
The evolution was favorable with disappearing signs of shock and weaning of oxygen on the 6th day. This observation illustrates the contribution of echocardiography in the diagnostic strategy and the therapeutic management of acute respiratory failure in the emergency department.
- |||||||||| ceftriaxone / Generic Mfg.
Stroke In Children-“Time To Act FAST”. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_1541;
Child was managed with IV fluids,antibiotics(ceftriaxone),antiplatelet drugs(aspirin & clopidogrel),antiemetics,physiotheraphy and other supportive measures. Pediaric strokes are relatively rare disease associated with significant morbidity and mortality so as to deserve the attention of clinicians.Hemiplegia is the most frequently reported sign and the most frequently affected artery is middle cerebral artery.Any child presented with new onset focal deficits,altered speech,altered mental status,seizures,headache or vomiting should be evaluated.MRI is the gold standard diagnosis of paediatric stroke.By emphasizing on pathway of care in diagnosis,stabilization of modifiable factors and management of childhood stroke the outcome is better.
- |||||||||| aspirin / Generic Mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
STEMI at 24 years old it is possible? () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_1537;
ECG reveals STEMI, CK-MB:0.3ng/ml, Troponin I:5ng/ml,WBC:18000/mcl It's possibleto have STEMI at 24 years old?The pacient suffer of coagulopathy? After cardiology review,a diagnossis is established:STEMI and receives the proper tratment:aspirin,clopidogrel,heparin,Actilyse The final step of managment was medical transfer by helicopter to a higher grade hospital in order to have PTCA
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Prognostic value of neutrophil lymphocyte ratio in stroke disability assessment. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_961;
In our experience the Stroke Code model allowed a STL rate in eligible patients and accomplishment of DTN time target comparable to previous data from larger high-resorce hospitals. We concluded that a low lymphocyte neutrophil ratio is an indicator of good functional prognosis at one year.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
A primer for a Tuscany stroke registry: looking back to go straight to the target. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_896;
Background: Intravenous thrombolysis with tissue plasminogen activator (Alteplase, tPA) is the current standard treatment for ischemic stroke within 4.5 h of symptom onset... A stroke registry is an usefool tool to monitor time-dependent patient management and it can be used to find pitfalls and delays, in order to allow EP to improve their troughput patient management and outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date: INTRECIS: Intravenous Thrombolysis Registry for Chinese Ischemic Stroke Within 4.5 h Onset (clinicaltrials.gov) - Sep 9, 2019
P=N/A, N=4000, Active, not recruiting,
The age group most severely affected by this condition was 61-70 years old, with 94 cases, followed by the group 71-80 years old, with 86 cases. Trial completion date: Aug 2019 --> Oct 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Thrombolysis for non-traumatic intra-ventricular hemorrhage in adults: a critical reappraisal. (Pubmed Central) - Sep 8, 2019
...Results from the CLEAR III multicenter trial suggest that a routine extra-ventricular drain, irrigation with alteplase reduced mortality but did not substantially improve functional outcomes compared with irrigation with saline...Currently no consensus has been reached and extrapolation of data from the literature does not permit to identify a uniform therapeutic approach but merely to outline some rational procedural modalities. Further research and studies are needed to compare the efficacy of the different fibrinolytic agents and protocols on functional outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Biomarker, Journal: NIHSS cut-point for predicting outcome in supra- vs infratentorial acute ischemic stroke. (Pubmed Central) - Sep 8, 2019
P3
In thrombolysis-eligible AIS patients, the NIHSS may underestimate clinical severity for infratentorial compared to supratentorial lesions for a similar prognosis for recovery. Because thrombolysis treatment has low effect on stroke outcome in patients with infratentorial AIS when baseline NIHSS score is more than 6, additional treatment such as endovascular treatment should be considered to improve stroke outcome.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Managing dysfunctional central venous access devices: a practical approach to urokinase thrombolysis. (Pubmed Central) - Sep 7, 2019
It is well recognised that urokinase usage differs widely and concerns were raised by clinicians about the variation of dose regimens nationally. The objective of the CVAD Focus Group was to address this issue and offer guidance in the management of suspected thrombosis of CVAD with urokinase using two algorithms for renal and non-renal dysfunctional CVAD and to audit prospectively the outcomes of intervention.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Comparison of alteplase and urokinase for pharmacomechanical thrombolysis of clotted hemodialysis access. (Pubmed Central) - Sep 6, 2019
Stenting was found to be associated with successful dialysis following thrombolysis on univariate analysis (odds ratio: 9.167, 95% confidence interval: 1.391-19.846, p = 0.021), although this was no longer significant in multivariate analysis (p = 0.078). Alteplase is an effective and safe alternative to urokinase for pharmacomechanical thrombolysis of clotted vascular access.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Trial completion date: T-TIME: A Trial of Low-dose Adjunctive alTeplase During prIMary PCI (clinicaltrials.gov) - Sep 6, 2019
P2, N=440, Completed,
. Active, not recruiting --> Completed | Trial completion date: Dec 2020 --> May 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Stroke Mimics: An Important Source of Bias in Acute Ischemic Stroke Research. (Pubmed Central) - Sep 3, 2019
Inclusion of stroke mimics led to an artificial inflation of a favorable discharge destination for our entire cohort. Our study highlights the potential for bias in reporting favorable outcomes if appropriate adjustment accounting for stroke mimics does not occur.
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