scholarly journals Distribution patterns of Gd-DTPA-enhanced magnetic resonance imaging after intravenous tissue plasminogen activator therapy for acute myocardial infarction.

1994 ◽  
Vol 58 (3) ◽  
pp. 199-205 ◽  
Author(s):  
SHIGERU FUKUZAWA ◽  
HIROYUKI WATANABE ◽  
KAZUHIRO SHIMADA ◽  
NAKOTO KATAGIRI ◽  
SHUN OZAWA
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Magnetic Resonance ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Distribution Patterns ◽  
Resonance Imaging ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

scholarly journals A Case Report on Concurrent Stroke and Myocardial Infarction

2021 ◽  
Vol 4 (1) ◽  
pp. 42-49
Author(s):  
Khairy M ◽  
Lu V ◽  
Ranasinghe N ◽  
Ranasinghe L
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cerebral Infarction ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Coronary Intervention ◽  
Intravenous Tissue Plasminogen Activator ◽  
Percutaneous Coronary ◽  
Tissue Plasminogen

Concurrent myocardial infarction and acute cerebral infarction is a rare and poorly studied phenomenon that presents a challenge to treat as both conditions are life threatening with narrow therapeutic windows. We present the case of a 70 year old female who presented with symptoms concerning for stroke. However, an electrocardiogram revealed she was also having an acute myocardial infarction. The decision was made to treat the stroke with intravenous tissue plasminogen activator. Unfortunately, the patient ultimately decompensated and died. There are many proposed etiologies of this phenomenon including cardiac thrombi leading to concurrent acute myocardial infarction and cerebral infarction, a primary myocardial infarction leading to a cerebral infarction, and a primary cerebral infarction leading to an acute myocardial infarction. Treatment options include simultaneous mechanical thrombectomy and percutaneous coronary intervention in a cardiac catheterization laboratory, or treating with the intravenous tissue plasminogen activator dose for a cerebral infarction and then potentially also proceeding to percutaneous coronary intervention. Ultimately, the management of this situation will depend on the patient’s specific situation including the type of stroke, the extent of irreversible tissue damage, and the hospital’s available resources. A randomized controlled study is difficult because of the rare occurrence of both presentations and a systematic review of the available literature may provide physicians with better insight as to how to approach a simultaneous acute myocardial infarction and acute cerebral infarction.

scholarly journals Comparison of two dose regimens of intravenous tissue plasminogen activator for acute myocardial infarction

1988 ◽  
Vol 61 (10) ◽  
pp. 723-728 ◽  
Author(s):  
Eric J. Topol ◽  
Barry S. George ◽  
Dean J. Kereiakes ◽  
Richard J. Candela ◽  
Charles W. Abbottsmith ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Endovascular Administration after Intravenous Infusion of Thrombolytic Agents for the Treatment of Patients with Acute Ischemic Strokes

Neurosurgery ◽  
2002 ◽  
Vol 50 (2) ◽  
pp. 251-260 ◽  
Author(s):  
Jose I. Suarez ◽  
Osama O. Zaidat ◽  
Jeffrey L. Sunshine ◽  
Robert Tarr ◽  
Warren R. Selman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Intracranial Hemorrhage ◽  
Recombinant Tissue Plasminogen Activator ◽  
Resonance Imaging ◽  
Vessel Occlusion ◽  
Perfusion Weighted Imaging ◽  
Tissue Plasminogen

ABSTRACT OBJECTIVE To determine the feasibility of combined intravenous and intra-arterial thrombolytic therapy for acute ischemic strokes and to evaluate its associated risks, using magnetic resonance imaging as a triage tool. Intravenous treatment followed by intra-arterial infusion may increase the rate of recanalization and lead to better clinical results, with reduced frequency of intracranial hemorrhage. METHODS Our Brain Attack Team evaluated patients who presented within 3 hours after symptom onset. Patients who did not demonstrate improvement and exhibited no evidence of intracranial hemorrhage on head computed tomographic scans were treated with intravenously administered recombinant tissue plasminogen activator (0.6 mg/kg) and underwent emergency magnetic resonance imaging of the head. T2-weighted turbo-gradient and spin echo and echo-planar diffusion- and perfusion-weighted imaging scans were obtained. Patients with evidence of imaging abnormalities indicating acute cortical infarction underwent cerebral angiography. After determination of vessel occlusion, intra-arterially administered urokinase (up to 750,000 units) or intra-arterially administered recombinant tissue plasminogen activator (maximal dose, 0.3 mg/kg) was used to achieve recanalization. RESULTS We treated 45 patients with this protocol. The mean age was 67 ± 13 years, and 58% of the patients were women. There was a significant improvement in National Institutes of Health Stroke Scale scores after treatment. There was good correlation between abnormal perfusion-weighted imaging findings and cerebral angiographic findings (complete vessel occlusion). The incidence of symptomatic intracranial hemorrhage was 4.4% in this cohort. Seven patients died in the hospital, and the majority of survivors (77%) experienced good outcomes (Barthel index of ≥95) 3 months after treatment. CONCLUSION Our data demonstrate that this protocol is feasible and that combined intravenous and intra-arterial thrombolysis to treat acute ischemic strokes is sufficiently safe to warrant further evaluation.

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