Successful Use of Tissue Plasminogen Activator for Saddle Pulmonary Embolism in Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage

2020 ◽  
Vol 144 ◽  
pp. 209-212
Author(s):  
Ken Porche ◽  
Christopher Robinson ◽  
Adam Polifka
Keyword(s):  
Pulmonary Embolism ◽  
Subarachnoid Hemorrhage ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Nonaneurysmal Subarachnoid Hemorrhage

Tissue plasminogen activator as a novel diagnostic aid in acute pulmonary embolism

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Julio Flores ◽  
Ángel García-Avello ◽  
Esther Alonso ◽  
Antonio Ruíz ◽  
Olga Navarrete ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Utility ◽  
Tissue Plasminogen ◽  
D Dimer

Background: We evaluated the diagnostic efficacy of tissue plasminogen activator (tPA), using an enzyme-linked immunosorbent assay (ELISA) and compared it with an ELISA D-dimer (VIDAS D-dimer) in acute pulmonary embolism (PE). Patients and methods: We studied 127 consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on a clinical probability pretest for PE and a strict protocol of imaging studies. A plasma sample to measure the levels of tPA and D-dimer was obtained at enrollment. Diagnostic accuracy for tPA and D-dimer was determined by the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity, predictive values, and the diagnostic utility of tPA with a cutoff of 8.5 ng/mL and D-dimer with a cutoff of 500 ng/mL, were calculated for PE diagnosis. Results: PE was confirmed in 41 patients (32 %). Areas under ROC curves were 0.86 for D-dimer and 0.71 for tPA. The sensitivity/negative predictive value for D-dimer using a cutoff of 500 ng/mL, and tPA using a cutoff of 8.5 ng/mL, were 95 % (95 % CI, 88–100 %)/95 % (95 % CI, 88–100 %) and 95 % (95 % CI, 88–100 %)/94 %), respectively. The diagnostic utility to exclude PE was 28.3 % (95 % CI, 21–37 %) for D-dimer and 24.4 % (95 % CI, 17–33 %) for tPA. Conclusions: The tPA with a cutoff of 8.5 ng/mL has a high sensitivity and negative predictive value for exclusion of PE, similar to those observed for the VIDAS D-dimer with a cutoff of 500 ng/mL, although the diagnostic utility was slightly higher for the D-dimer.

Stroke and Other Cerebrovascular Diseases

2021 ◽  
Author(s):  
Scott E. Kasner ◽  
Christina A Wilson
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Best Practice ◽  
Recombinant Tissue Plasminogen Activator ◽  
Vessel Occlusion ◽  
Risk Factor Management ◽  
Presenting Symptoms ◽  
Tissue Plasminogen

Stroke is a leading cause of neurologic morbidity and mortality, and rapid treatment is key for a good outcome. This review addresses the epidemiology, common presenting symptoms, causes, and treatment of ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Current recommendations for the emergent evaluation and treatment of an acute ischemic stroke are highlighted, including recently updated indications and contraindications for intravenous recombinant tissue plasminogen activator administration and recent guidelines for the expanded role of endovascular mechanical embolectomy for stroke due to acute large vessel occlusion. An algorithm of diagnostic evaluations to assist with identification of the cause of ischemic stroke is offered. Evidence-based primary and secondary stroke prevention is discussed, including the ideal choice of antithrombotic based on identified stroke mechanism and optimal risk factor management. Best practice supportive measures for the post-stroke patient are highlighted, including recent guidelines for the management of elevated intracranial pressure. Management of uncommon causes of ischemic stroke is also addressed.  This review contains 7 figures, 9 tables, and 84 references. Key Words:Intracerebral hemorrhage, ischemic stroke, recombinant tissue plasminogen activator, subarachnoid hemorrhage, antiplatelet therapy, endovascular therapy

Effect of BQ-123 and Tissue Plasminogen Activator on Vasospasm After Subarachnoid Hemorrhage in Monkeys

Stroke ◽  
1996 ◽  
Vol 27 (9) ◽  
pp. 1629-1633 ◽  
Author(s):  
Chul-Jin Kim ◽  
Mohammed Bassiouny ◽  
R. Loch Macdonald ◽  
Bryce Weir ◽  
Lydia M. Johns
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tissue Plasminogen
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