scholarly journals Alteplase for acute ischemic stroke: 2 years in a community hospital without previous experience in stroke thrombolysis

Critical Care ◽  
2008 ◽  
Vol 12 (Suppl 2) ◽  
pp. P127
Author(s):  
A Estella ◽  
A Sainz de Baranda ◽  
E Moreno ◽  
MJ Galan ◽  
E Leal ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Community Hospital ◽  
Previous Experience ◽  
Stroke Thrombolysis

Should Tenecteplase be Given in Clinical Practice for Acute Ischemic Stroke Thrombolysis?

Stroke ◽  
2021 ◽  
Author(s):  
Jukka Putaala ◽  
Jeffrey L. Saver ◽  
May Nour ◽  
Dawn Kleindorfer ◽  
Mollie McDermott ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Practice ◽  
Acute Ischemic Stroke ◽  
Stroke Thrombolysis

scholarly journals New standardized nursing cooperation workflow to reduce stroke thrombolysis delays in patients with acute ischemic stroke

2017 ◽  
Vol Volume 13 ◽  
pp. 1215-1220 ◽  
Author(s):  
Yan Zhou ◽  
Zhuojun Xu ◽  
Jiali Liao ◽  
Fangming Feng ◽  
Lai Men ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Thrombolysis

scholarly journals Pre-hospital causes for delayed arrival in acute ischemic stroke before and during the COVID-19 pandemic: A study at two stroke centers in Egypt

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254228
Author(s):  
Hany M. Aref ◽  
Hossam Shokri ◽  
Tamer M. Roushdy ◽  
Fatma Fathalla ◽  
Nevine M. El Nahas
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Medical Staff ◽  
Pronounced Effect ◽  
Previous Experience ◽  
Stroke Outcome ◽  
The Public ◽  
Early Arrival ◽  
To Receive

Background In the current study we investigated the causes of pre-hospital delay as this can compromise the patient’s chance to receive thrombolytic therapy and thus impact stroke outcome. Methods We surveyed 254 patients regarding reasons for delayed and early arrival to hospital after acute ischemic stroke. The survey was performed over five months, spanning a period pre- and during COVID-19 (between December 7, 2019 and May 10, 2020). Results A total of 71.2% of patients arrived beyond four hours of onset of ischemic stroke. The commonest cause for delay pre-Covid-19 was receiving treatment in a non-stroke hospital, while that during COVID-19 was fear of infection and lock down issues. Not realizing the urgency of the condition and stroke during sleep were common in both periods. Early arrival because of the patient’s previous experience with stroke accounted for approximately 25% of cases in both periods. The effect of media was more evident during COVID-19, accounting for 47.7% of cases. Conclusion Pre-hospital delay secondary to misperception of the urgency of stroke and management in a non-stroke hospital reflect the lack of awareness among the public and medical staff. This concept is emphasized by early arrival secondary to previous experience with stroke and the pronounced effect of media in the time of COVID-19.

Abstract 2418: Reducing Door to Needle Time for Intravenous Alteplase in Community Hospital Based Primary Stroke Centers

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Raul Guisado ◽  
Karen de la Cuesta ◽  
Linda Catalli
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Acute Ischemic Stroke ◽  
Community Hospital ◽  
Historical Data ◽  
Stroke Onset ◽  
National Treatment ◽  
Community Based ◽  
Management Protocol ◽  
Intravenous Alteplase

Intravenous alteplase (i.v. t-PA) for ischemic stroke is most effective when given early after stroke onset. The current national treatment initiative, Target:Stroke aims to administer i.v. t-PA within 60 minutes of patient’s arrival to the ED. This goal is challenging for community based primary stroke centers that do not have 24 hours in-house neurologists or radiologists and who are not able to mix alteplase in the ED. In 2010, we conducted a focused review of Stroke Alert Timelines in two community based Primary Stroke Centers in Santa Clara, California. This review led to the hypothesis that door-to-needle times for i.v. alteplase in ischemic stroke could be reduced by improving communication between key responders and by expediting the delivery of i.v. alteplase from pharmacy to the ED. METHODS: In January 2011 we implemented a new Emergency Room protocol for management of patients with acute ischemic stroke ( Fig ) and compared its performance with recent historical data in two community hospital based PSCs. This protocol emphasizes prompt communication between ED physician, on-call neurologist and radiology and expedites the delivery of i.v. alteplase to the ED. FINDINGS: The average door to needle time for patients treated between January 2009 and December 2010 was 89.5 ± 35.7 min (median 77 min). During this period, two patients (3.1%) received the drug within 60 minutes of arrival to the ED. The average door to needle time for patients treated between January 2011 and July 2011, was 70.7 ± 28.9 min, (median 60 min, p < 0.02). During this period, fourteen patients (58.3%) received i.v. t-PA within 60 minutes of arrival to the ED. CONCLUSION: an improved management protocol that optimizes communication between ED physician, neurologist, radiologist and pharmacy and makes alteplase promptly available at bedside, can significantly improve the door to needle time for i.v. alteplase in community hospital based primary stroke centers.

MSC 2021 Virtual E-Abstract

2021 ◽  
Vol 3 (3) ◽  
pp. 37-42
Author(s):  
Malaysian Stroke Conference
Keyword(s):  
Growth Hormone ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Healthcare Providers ◽  
Hormone Deficiency ◽  
Therapeutic Effects ◽  
Diagnostic Dilemma ◽  
Brain Recovery ◽  
Stroke Thrombolysis

1. Factors Influencing The Uptake Of Stroke Thrombolysis In Malaysia: A Case Study From The Healthcare Providers’ Perspective.2. Growth Hormone And Ischemic Stroke: Focus On Growth Hormone Deficiency And Therapeutic Effects Of Growth Hormone On Brain Recovery.3. Predictors Of Post-Thrombolysis Intracerebral Haemorrhage In Patients With Acute Ischemic Stroke.4. Predictors of Mortality In Thrombolysed Acute Ischemic Stroke Patients of Seberang Jaya Hospital.5. Bilateral Dejerine Syndrome: A Case Report with Diagnostic Dilemma.6. Outcome Of Ischemic Stroke Thrombolysis Treatment In Seberang Jaya Hospital, A Single Center 9 Years Review: 2012-2020.

PREDICTORS THE RISK OF SYMPTOMATIC INTRACEREBRAL HEAMORHAGE AFTER THROMBOLYTIC THERAPY WITH RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN ACUTE ISCHEMIC STROKE

2017 ◽  
pp. 64-67
Author(s):  
Dinh Thuyen Nguyen ◽  
Duy Ton Mai ◽  
Viet Phuong Dao ◽  
Anh Tuan Nguyen
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Brain Ct ◽  
Tissue Plasminogen ◽  
History Of ◽  
Stroke Thrombolysis

Objective: to evaluate predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. Methods: observative study on 54 patients with acute ischemic stroke at Emergency Department, Bach Mai hospital from 01/2010 to 10/2016. Results: Predictors the risk of symptomatic intracerebral heamorrhage were: age above 70 (OR 2,76; 95% CI 0,73 – 10,52; p = 0,12), time from onset to treatment (OR 1,03; 95% CI 0,34 – 3,13; p = 0,95), systolic blood pressure ≥ 140 mmHg (OR 2,0; 95% CI 0,61 – 6,51; p = 0,24), NIHSS score above 12 (OR 3,13; 95% CI 0,63 – 15,51; p = 0,138), glycemia above 10 mmol/l (OR 8,94; 95% CI 1,51 – 51,73; p = 0,003), fibrillation atrial (OR 1,49; 95% 0,49 – 4,56; p = 0,33), history of diebete (OR 6,4; 95% CI 0,67 – 61,03; p = 0,06), history of anticoagulation (OR 1,07; 95% CI 0,22 – 5,11; p = 0,63), history of cerebral infarction (OR 1,49; 95% CI 0,183 – 12,184; p = 0,707), sign of early brain CT (OR 6,14; 95% CI 1,01 – 39,93; p = 0,048). Conclusion: glucose above 10 mmol/l and sign of early brain CT were predictors the risk of symptomatic intracerebral heamorrhage after thrombolytic therapy with recombinant tissue plasminogen activator in acute ischemic stroke. Key words: stroke, thrombolysis, predictor, heamorrhage conversion

scholarly journals Acute stroke thrombolysis in infective endocarditis

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880762 ◽  
Author(s):  
Abdulaziz Ashkanani ◽  
Zouhair Bitar ◽  
Osama Maadrani
Keyword(s):  
Ischemic Stroke ◽  
Infective Endocarditis ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Hemorrhagic Transformation ◽  
Successful Outcome ◽  
Tissue Plasminogen ◽  
Stroke Thrombolysis

Intravenous recombinant tissue plasminogen activator is not recommended for the treatment of acute ischemic stroke in patients with infective endocarditis due to the risk of hemorrhagic transformation of septic emboli and few reported cases in the literature. Here, we present the successful outcome of intravenous recombinant tissue plasminogen activator administration for a patient with acute ischemic stroke who was later found to have infective endocarditis. This case adds to the small number of cases reported in the literature.

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