Validation of FLAIR Hyperintense Lesions as Imaging Biomarkers to Predict the Outcome of Acute Stroke after Intra-Arterial Thrombolysis following Intravenous Tissue Plasminogen Activator

2013 ◽  
Vol 35 (5) ◽  
pp. 461-468 ◽  
Author(s):  
Jong-Won Chung ◽  
Kyeong Joon Kim ◽  
Won-Young Noh ◽  
Myung Suk Jang ◽  
Mi Hwa Yang ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Imaging Biomarkers ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Arterial Thrombolysis

Acute stroke thrombolysis with intravenous tissue plasminogen activator in an Australian tertiary hospital

2003 ◽  
Vol 178 (7) ◽  
pp. 324-328 ◽  
Author(s):  
Cassandra E I Szoeke ◽  
Mark W Parsons ◽  
Kenneth S Butcher ◽  
Tracey A Baird ◽  
Peter J Mitchell ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tertiary Hospital ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Stroke Thrombolysis

scholarly journals Sex and Race‐Ethnic Disparities in Door‐to‐CT Time in Acute Ischemic Stroke: The Florida Stroke Registry

2021 ◽  
Author(s):  
Sai P. Polineni ◽  
Enmanuel J. Perez ◽  
Kefeng Wang ◽  
Carolina M. Gutierrez ◽  
Jeffrey Walker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Secondary Analysis ◽  
Ethnic Disparities ◽  
Stroke Registry ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Background Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race‐ethnic and sex differences in door‐to‐CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry). Methods and Results Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator‐treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87–0.93) and Black (OR, 0.88; CI, 0.84–0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01–1.14), to achieve DTCT ≤25. In a secondary analysis among intravenous tissue plasminogen activator‐treated patients, 81% of patients achieved DTCT ≤25. In this subgroup, women were less likely to receive DTCT ≤25 (0.85, 0.77–0.94) whereas no significant differences were observed by race or ethnicity. Conclusions In the FSR, there was considerable improvement in acute stroke care metric DTCT ≤25 in 2018 in comparison to 2010. However, sex and race‐ethnic disparities persist and require further efforts to improve performance and reduce these disparities.

scholarly journals Endovascular therapy for acute stroke: Quo vadis?

2013 ◽  
Vol 02 (02) ◽  
pp. 119-123
Author(s):  
Venkatesh Madhugiri ◽  
Paritosh Pandey
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Endovascular Therapy ◽  
Stent Retriever ◽  
Current Status ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Quo Vadis ◽  
Iv Tpa

Abstract Endovascular therapy (EVT) has gained vogue in the management of patients with acute stroke. Newer stent-retriever devices have led to better recanalization rates. In many centers, EVT is slowly being used as an add on to or in some instances, even as an alternative to intravenous tissue plasminogen activator (IV tPA). The publication of the results of the SYNTHESIS expansion, Interventional Management of Stroke III and Mechanical Retrieval Recanalization of Stroke Clots Using Embolectomy trials in 2013 has questioned the enthusiastic use of EVT in acute stroke. They demonstrate that EVT (using a variety of devices) is no superior to IV tPA in the management of acute stroke. In the light of these controversial findings, we review the current status of EVT in the management of acute stroke.

The randomized study of endovascular therapy with versus without intravenous tissue plasminogen activator in acute stroke with ICA and M1 occlusion (SKIP study)

2019 ◽  
Vol 14 (7) ◽  
pp. 752-755 ◽  
Author(s):  
Kentaro Suzuki ◽  
Kazumi Kimura ◽  
Masataka Takeuchi ◽  
Masafumi Morimoto ◽  
Ryuzaburo Kanazawa ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Endovascular Therapy ◽  
Randomized Study ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Bridging Therapy ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Rationale Bridging therapy with endovascular therapy (EVT) and intravenous thrombolysis (IVT) has been reported to improve outcomes for acute stroke patients with large-vessel occlusion in the anterior circulation. While the IVT may increase the reperfusion rate, the risk of hemorrhagic complications increases. Whether EVT without IVT (direct EVT) is equally effective as bridging therapy in acute stroke remains unclear. Aim This randomized study of endovascular therapy with versus without intravenous tissue plasminogen activator for acute stroke with ICA and M1 occlusion aims to clarify the efficacy and safety of direct EVT compared with bridging therapy. Methods and design This is an investigator-initiated, multicenter, prospective, randomized, open-treatment, blinded-endpoint clinical trial. The target patient number is 200, comprising 100 patients receiving direct EVT and 100 receiving bridging therapy. Study outcome The primary efficacy endpoint is a modified Rankin Scale score of 0–2 at 90 days. Safety outcome measures are any intracranial hemorrhage at 24 h. Discussion This trial may help determine whether direct EVT should be recommended as a routine clinical strategy for ischemic stroke patients within 4.5 h from onset. Direct EVT would then become the choice of therapy in stroke centers with endovascular facilities. Trial registration UMIN000021488.

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