Distant haemorrhagic effects in intra-arterial Tissue Plasminogen Activator The effect of a bolus dose

1994 ◽  
Vol 80 (2) ◽  
pp. 66-70
Author(s):  
N P J Cripps ◽  
A S Ward
Keyword(s):  
Continuous Infusion ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Bolus Dose ◽  
Entry Site ◽  
Arterial Tissue ◽  
Tissue Plasminogen ◽  
Peripheral Arterial ◽  
Haemorrhage Rate ◽  
Arterial Thrombolysis

AbstractDetails are reported of four patients who developed serious distant haemorrhagic complications while undergoing peripheral arterial thrombolysis with intra-arterial tissue plasminogen activator (t-PA). The thrombolytic regime comprised a 20 mg bolus of t-PA followed by a continuous infusion of 1 mg/hr. Four additional cases of haemorrhage at the catheter entry site were also encountered in a group of 23 patients exposed to the bolus-infusion t-PA regimen. The high haemorrhage rate (31 % ) is a significant disadvantage of this thrombolytic protocol.

Tissue plasminogen activator in peripheral arterial thrombolysis

1990 ◽  
Vol 77 (8) ◽  
pp. 954-955
Author(s):  
K. Dawson ◽  
G. Stansby ◽  
R. Novell ◽  
D. Hehir ◽  
D. C. Berridge ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Peripheral Arterial ◽  
Arterial Thrombolysis

Tissue plasminogen activator in peripheral arterial thrombolysis

1990 ◽  
Vol 77 (2) ◽  
pp. 179-182 ◽  
Author(s):  
D. C. Berridge ◽  
R. H. S. Gregson ◽  
G. S. Makin ◽  
B. R. Hopkinson
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Peripheral Arterial ◽  
Arterial Thrombolysis

Fibrinolytic Profiles in Local Low-Dose Thrombolysis with Streptokinase and Recombinant Tissue Plasminogen Activator

1989 ◽  
Vol 61 (02) ◽  
pp. 275-278 ◽  
Author(s):  
D C Berridge ◽  
J J Earnshawl ◽  
J C Westby ◽  
G S Makin ◽  
B R Hopkinson
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Low Dose ◽  
Recombinant Tissue Plasminogen Activator ◽  
Systemic Effect ◽  
Entry Site ◽  
Tissue Plasminogen ◽  
Post Infusion ◽  
Peripheral Arterial ◽  
Fibrinolytic Parameters

SummaryFibrinolytic parameters have been monitored in 44 patients undergoing local low-dose intra-arterial thrombolysis for acute peripheral arterial ischaemia. Streptokinase (Sk), at a dose of 5,000 units/hr with 250 units/hr heparin, was used in 23 patients and recombinant tissue plasminogen activator (r-tPA) at a dose of 0.5 mg/hr was used in 21 patients. Successful lysis was seen in 18 (86%) patients following r-tPA and in 15 (65%) patients following streptokinase. There were 4 minor haematomas in each group usually at the catheter entry site. Both agents produced a systemic effect, which was still seen 12 hours post-infusion. However, that produced by r-tPA was delayed and significantly reduced compared to that produced by Sk.These results confirm the relative fibrin specificity of r-tPA. When used as a continuous low-dose intra-arterial infusion, r-tPA offers a significantly lower, potentially safer, systemic effect than conventional therapy with streptokinase.

Abstract 168: Outcomes of Intra-Arterial Tissue Plasminogen Activator Rescue Therapy During Stroke Thrombectomy-Insights From the STAR Collaboration

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Eyad Almallouhi ◽  
Sami Al kasab ◽  
Ali Alawieh ◽  
Reda M Chalhoub ◽  
Mohammad Anadani ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Rescue Therapy ◽  
Adjunctive Treatment ◽  
Control Group ◽  
Arterial Tissue ◽  
Tissue Plasminogen

Introduction: Intra-arterial tissue plasminogen activator (IA-tPA) can be used as rescue therapy during mechanical thrombectomy for stroke patients, mostly in the setting of distal occlusion. The outcomes of IA-tPA has not been assessed in large-scale multi-center studies yet. Methods: We used data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which included prospectively maintained databases of 11 thrombectomy-capable stroke centers in the US, Europe, and Asia. We compared the baseline characteristics, procedural metrics, rate of symptomatic intracranial hemorrhage (sICH), and long-term functional outcomes between thrombectomy patients who received rescue IA-tPA and a control group of thrombectomy patients with matched age, National Institute of Health stroke scale (NIHSS) on presentation, location of occlusion and IV-tPA receipt. Results: A total of 2827 thrombectomy patients were included in the STAR registry. Out of those, 205 patients received IA-tPA. We matched 191 patients from the IA-tPA group with a control group of 191 patients (table 1). No difference was seen in age, sex, race, vascular risk factors, or Alberta Stroke Program Early CT (ASPECT) score between both groups. In addition, procedural metrics, including onset to groin time, the procedure duration, and rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score≥2b) were similar. Finally, similar outcomes were noted in both groups, including the rate of sICH and good 90-day functional outcome (modified Rankin scale≤2). Conclusion: The use of IA-tPA as an adjunctive treatment to mechanical thrombectomy was safe but did not result in a higher rate of successful recanalization or good long-term functional outcomes.

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