scholarly journals Intravenous Thrombolysis With Low-Dose Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke

Stroke ◽  
2010 ◽  
Vol 41 (3) ◽  
Author(s):  
Pei Kee Loh ◽  
Vijay K. Sharma
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Low Dose ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Association of admission leukocyte count with clinical outcomes in acute ischemic stroke patients undergoing intravenous thrombolysis with recombinant tissue plasminogen activator

2020 ◽  
Vol 17 ◽  
Author(s):  
Jie Chen ◽  
Fu-Liang Zhang ◽  
Shan Lv ◽  
Hang Jin ◽  
Yun Luo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Leukocyte Count ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Functional Independence ◽  
Tissue Plasminogen ◽  
Poor Outcomes

Objective:: Increased leukocyte count are positively associated with poor outcomes and all-cause mortality in coronary heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important. We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients. Methods:: This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of symptom onset between January 2016 and December 2018. We assessed outcomes including short-term hemorrhagic transformation (HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0–2 or 0–1). Results:: Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and 211 (36.4%) exhibited functional independence (mRS score: 0–2). Multivariable logistic regression revealed admission leukocyte count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3–6, odds ratio (OR): 1.076, 95% confidence interval (CI): 1.003–1.154, p=0.041) and 7.8% (mRS score: 2–6, OR: 1.078, 95% CI: 1.006–1.154, p=0.033). Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and lymphocyte count were not associated with 3-month functional outcomes or 3-month mortality. Conclusion:: Lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients undergoing rt-PA treatment.

scholarly journals Coronary aspiration thrombectomy after using intravenous recombinant tissue plasminogen activator in a patient with acute ischemic stroke: a case report

2019 ◽  
Vol 47 (9) ◽  
pp. 4551-4556 ◽  
Author(s):  
Ton Mai Duy ◽  
Phuong DaoViet ◽  
Dung Nguyen Tien ◽  
Quang-Anh Nguyen ◽  
Thien Nguyen Tat ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Low Dose ◽  
Recombinant Tissue Plasminogen Activator ◽  
Aspiration Thrombectomy ◽  
Tissue Plasminogen ◽  
New Strategy

The complication of myocardial infarction after using intravenous recombinant tissue plasminogen activator (rt-PA) in patients with acute ischemic stroke is rare. Several of these cases have been reported in the first 3 hours after infusion of rt-PA. There is controversy on how to manage treatment of the coronary artery, such as intravenous anticoagulants and antiplatelets, at the same time. We introduce a new strategy for treatment of a patient who had ischemic stroke and developed myocardial infarction after intravenous rt-PA therapy. Our case had coronary and cerebral intervention in combination with low-dose intravenous rt-PA. He was successfully treated for coronary occlusion with aspiration thrombectomy.

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