scholarly journals CT Perfusion ASPECTS in the Evaluation of Acute Ischemic Stroke: Thrombolytic Therapy Perspective

2011 ◽  
Vol 1 (1) ◽  
pp. 6-16 ◽  
Author(s):  
Niko Sillanpaa ◽  
Jukka T. Saarinen ◽  
Harri Rusanen ◽  
Jari Hakomaki ◽  
Arto Lahteela ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Ct Perfusion

scholarly journals Reflection on the Past, Present, and Future of Thrombolytic Therapy for Acute Ischemic Stroke

Neurology ◽  
2021 ◽  
Vol 97 (20 Supplement 2) ◽  
pp. S170-S177
Author(s):  
Stacie L. Demel ◽  
Robert Stanton ◽  
Yasmin N. Aziz ◽  
Opeolu Adeoye ◽  
Pooja Khatri
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Ct Perfusion ◽  
Critical Role ◽  
Recombinant Tissue Plasminogen Activator ◽  
Initial Time ◽  
Stroke Treatment ◽  
The Past ◽  
Therapeutic Landscape

More than 25 years have passed since the US Food and Drug Administration approved IV recombinant tissue plasminogen activator (alteplase) for the treatment of acute ischemic stroke. This landmark decision brought a previously untreatable disease into a new therapeutic landscape, providing inspiration for clinicians and hope to patients. Since that time, the use of alteplase in the clinical setting has become standard of care, continually improving with quality measures such as door-to-needle times and other metrics of specialized stroke unit care. The past decade has seen more widespread use of alteplase in the prehospital setting with mobile stroke units and telestroke and beyond initial time windows via the use of CT perfusion or MRI. Simultaneously, the position of alteplase is being challenged by new lytics and by the concept of its bypass altogether in the era of endovascular therapy. We provide an overview of alteplase, including its earliest trials and how they have shaped the current therapeutic landscape of ischemic stroke treatment, and touch on new frontiers for thrombolytic therapy. We highlight the critical role of thrombolytic therapy in the past, present, and future of ischemic stroke care.

Predictive value of time-variant color-coded multiphase CT angiography (mCTA) regarding clinical outcome of acute ischemic stroke: in comparison with conventional mCTA and CT perfusion

2020 ◽  
pp. 028418512098177
Author(s):  
Yu Lin ◽  
Nannan Kang ◽  
Jianghe Kang ◽  
Shaomao Lv ◽  
Jinan Wang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Ct Perfusion ◽  
Roc Curves ◽  
Multivariate Logistic Regression Model ◽  
Infarct Core ◽  
Predictive Values ◽  
Significant Difference ◽  
Core Volume

Background Color-coded multiphase computed tomography angiography (mCTA) can provide time-variant blood flow information of collateral circulation for acute ischemic stroke (AIS). Purpose To compare the predictive values of color-coded mCTA, conventional mCTA, and CT perfusion (CTP) for the clinical outcomes of patients with AIS. Material and Methods Consecutive patients with anterior circulation AIS were retrospectively reviewed at our center. Baseline collateral scores of color-coded mCTA and conventional mCTA were assessed by a 6-point scale. The reliabilities between junior and senior observers were assessed by weighted Kappa coefficients. Receiver operating characteristic (ROC) curves and multivariate logistic regression model were applied to evaluate the predictive capabilities of color-coded mCTA and conventional mCTA scores, and CTP parameters (hypoperfusion and infarct core volume) for a favorable outcome of AIS. Results A total of 138 patients (including 70 cases of good outcomes) were included in our study. Patients with favorable prognoses were correlated with better collateral circulations on both color-coded and conventional mCTA, and smaller hypoperfusion and infarct core volume (all P < 0.05) on CTP. ROC curves revealed no significant difference between the predictive capability of color-coded and conventional mCTA ( P = 0.427). The predictive value of CTP parameters tended to be inferior to that of color-coded mCTA score (all P < 0.001). Both junior and senior observers had consistently excellent performances (κ = 0.89) when analyzing color-coded mCTA maps. Conclusion Color-coded mCTA provides prognostic information of patients with AIS equivalent to or better than that of conventional mCTA and CTP. Junior radiologists can reach high diagnostic accuracy when interpreting color-coded mCTA images.

scholarly journals Outcomes of Thrombolytic Therapy for Acute Ischemic Stroke in Chinese Patients

Stroke ◽  
2010 ◽  
Vol 41 (5) ◽  
pp. 885-890 ◽  
Author(s):  
A-Ching Chao ◽  
Hung-Yi Hsu ◽  
Chih-Ping Chung ◽  
Chung-Hsiang Liu ◽  
Chih-Hung Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Chinese Patients

scholarly journals A Description of Canadian and United States Physician Reimbursement for Thrombolytic Therapy Administration in Acute Ischemic Stroke

Stroke ◽  
2005 ◽  
Vol 36 (3) ◽  
pp. 682-687 ◽  
Author(s):  
Dawn Kleindorfer ◽  
Michael D. Hill ◽  
Daniel Woo ◽  
Thomas Tomsick ◽  
Arthur Pancioli ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Physician Reimbursement
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