GENDER-RELATED DIFFERENCES IN POLISH ACUTE STROKE PATIENTS TREATED WITH INTRAVENOUS THROMBOLYSIS.

2017 ◽  
Author(s):  
Malgorzata Wiszniewska
Keyword(s):  
Acute Stroke ◽  
Intravenous Thrombolysis ◽  
Stroke Patients

scholarly journals In-Hospital Intravenous Thrombolysis Offers No Benefit in Mechanical Thrombectomy in Optimized Tertiary Stroke Center Setting

2020 ◽  
Author(s):  
Juha-Pekka Pienimäki ◽  
Jyrki Ollikainen ◽  
Niko Sillanpää ◽  
Sara Protto
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Mechanical Thrombectomy ◽  
Clinical Laboratory ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Ordinal Logistic Regression Analysis ◽  
Stroke Center

Abstract Purpose Mechanical thrombectomy (MT) is the first-line treatment in acute stroke patients presenting with large vessel occlusion (LVO). The efficacy of intravenous thrombolysis (IVT) prior to MT is being contested. The objective of this study was to evaluate the efficacy of MT without IVT in patients with no contraindications to IVT presenting directly to a tertiary stroke center with acute anterior circulation LVO. Materials and Methods We collected the data of 106 acute stroke patients who underwent MT in a single high-volume stroke center. Patients with anterior circulation LVO eligible for IVT and directly admitted to our institution who subsequently underwent MT were included. We recorded baseline clinical, laboratory, procedural, and imaging variables and technical, imaging, and clinical outcomes. The effect of intravenous thrombolysis on 3-month clinical outcome (mRS) was analyzed with univariate tests and binary and ordinal logistic regression analysis. Results Fifty-eight out of the 106 patients received IVT + MT. These patients had 2.6-fold higher odds of poorer clinical outcome in mRS shift analysis (p = 0.01) compared to MT-only patients who had excellent 3-month clinical outcome (mRS 0–1) three times more often (p = 0.009). There were no significant differences between the groups in process times, mTICI, or number of hemorrhagic complications. A trend of less distal embolization and higher number of device passes was observed among the MT-only patients. Conclusions MT without prior IVT was associated with an improved overall three-month clinical outcome in acute anterior circulation LVO patients.

Abstract WP36: Post-ischemic Hyperperfusion After Reperfusion Therapy Predicts Hemorrhagic Transformation

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Shuhei Okazaki ◽  
Takeshi Yoshimoto ◽  
Hiroshi Yamagami ◽  
Katsufumi Kajimoto ◽  
Mikito Hayakawa ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Three Dimensional ◽  
Intravenous Thrombolysis ◽  
Reperfusion Therapy ◽  
Hemorrhagic Transformation ◽  
Regional Cerebral Blood ◽  
Stroke Patients ◽  
Mca Occlusion ◽  
Blood Flow Ratio ◽  
The Relationship

Background and Purpose: Post-ischemic hyperperfusion has been considered as a risk factor of hemorrhagic transformation and poor prognosis. To date, however, there is a lack of data about the pathological significance of hyperperfusion after reperfusion therapy. In this study, we evaluated the relationship between hemorrhagic transformation and post-ischemic hyperperfusion after reperfusion therapy by using arterial spin labeled perfusion MRI (ASL) and 123 I IMP-SPECT. Methods: We retrospectively collected data of acute stroke patients with middle cerebral artery (MCA) occlusion who received intravenous thrombolysis and/or endovascular therapy, and underwent pulsed ASL using Q2TIPS-FAIR with 3D-TGSE readout and 123 I IMP-SPECT using dual-table ARG method within 14 days of stroke onset from November 2015 to June 2016. Ipsilateral-contralateral regional cerebral blood flow ratio (IC ratio) was calculated by using three-dimensional stereotactic ROI template (3DSRT) software. Results: Among 47 consecutive acute stroke patients with the MCA occlusion who received reperfusion therapy, 21 underwent only ASL and 10 underwent both ASL and SPECT after reperfusion therapy. The IC ratio of ASL was well correlated with that of SPECT in the MCA territory (r=0.65, p <0.001). Hemorrhagic transformation was observed in 7 patients. IC ratio was higher in patients with hemorrhagic transformation after reperfusion therapy than those without hemorrhagic transformation (2.19±0.35 vs 0.99±0.19, p=0.005). Focal post-ischemic hyperperfusion (IC ratio >1.5) was detected in 7 of 31 patients (23%). The presence of post-ischemic hyperperfusion was significantly associated with hemorrhagic transformation after reperfusion therapy (odds ratio 9.3, 95% confidence interval 1.4 to 64.0, p=0.03). Conclusions: Post-ischemic hyperperfusion detected by ASL predicts hemorrhagic transformation after reperfusion therapy. ASL hyperperfusion may indicate the disruption of blood brain barrier after reperfusion therapy.

Predictors of good clinical outcome in acute stroke patients treated with intravenous thrombolysis

2011 ◽  
Vol 123 (5) ◽  
pp. 339-344 ◽  
Author(s):  
D. Šaňák ◽  
R. Herzig ◽  
J. Zapletalová ◽  
D. Horák ◽  
M. Král ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Good Clinical Outcome

Should we exclude acute stroke patients with previous intracerebral hemorrhage from receiving intravenous thrombolysis?

2016 ◽  
Vol 11 (7) ◽  
pp. 783-790 ◽  
Author(s):  
Sang-Hwa Lee ◽  
Beom Joon Kim ◽  
Moon-Ku Han ◽  
Tai Hwan Park ◽  
Kyung Bok Lee ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Acute Stroke ◽  
Intravenous Thrombolysis ◽  
Stroke Patients

scholarly journals Comparison of Rates and Outcomes of Readmission to Index vs Non-index Hospitals After Intravenous Thrombolysis in Acute Stroke Patients

Cureus ◽  
2020 ◽  
Author(s):  
Kristina Shkirkova ◽  
Michelle Connor ◽  
Drew M Hodis ◽  
Krista Lamorie-Foote ◽  
Arati Patel ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Intravenous Thrombolysis ◽  
Stroke Patients

scholarly journals Cohort profile: Thrombolysis in Ischemic Stroke Patients (TRISP): a multicentre research collaboration

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023265 ◽  
Author(s):  
Jan F Scheitz ◽  
Henrik Gensicke ◽  
Sanne M Zinkstok ◽  
Sami Curtze ◽  
Marcel Arnold ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Functional Outcome ◽  
Research Collaboration ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Acute Stroke Care ◽  
Laboratory Findings ◽  
Endovascular Thrombectomy ◽  
Multicentre Research

PurposeThe ThRombolysis in Ischemic Stroke Patients (TRISP) collaboration aims to address clinically relevant questions about safety and outcomes of intravenous thrombolysis (IVT) and endovascular thrombectomy. The findings can provide observational information on treatment of patients derived from everyday clinical practice.ParticipantsTRISP is an open, investigator-driven collaborative research initiative of European stroke centres with expertise in treatment with revascularisation therapies and maintenance of hospital-based registries. All participating centres made a commitment to prospectively collect data on consecutive patients with stroke treated with IVT using standardised definitions of variables and outcomes, to assure accuracy and completeness of the data and to adapt their local databases to answer novel research questions.Findings to dateCurrently, TRISP comprises 18 centres and registers >10 000 IVT-treated patients. Prior TRISP projects provided evidence on the safety and functional outcome in relevant subgroups of patients who were excluded, under-represented or not specifically addressed in randomised controlled trials (ie, pre-existing disability, cervical artery dissections, stroke mimics, prior statin use), demonstrated deficits in organisation of acute stroke care (ie, IVT during non-working hours, effects of onset-to-door time on onset-to-needle time), evaluated the association between laboratory findings on outcome after IVT and served to develop risk estimation tools for prediction of haemorrhagic complications and functional outcome after IVT.Future plansFurther TRISP projects to increase knowledge of the effect and safety of revascularisation therapies in acute stroke are ongoing. TRISP welcomes participation and project proposals of further centres fulfilling the outlined requirements. In the future, TRISP will be extended to include patients undergoing endovascular thrombectomy.

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