Guidelines on intravenous thrombolysis in the treatment of acute cerebral infarction – 2021 version

2021 ◽  
Vol 84/117 (4) ◽  
Author(s):  
Jiří Neumann ◽  
Daniel Šaňák ◽  
Aleš Tomek ◽  
Michal Bar ◽  
Roman Herzig ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction

Comparative study on the efficacy and safety of alteplase and urokinase in the treatment of acute cerebral infarction

2020 ◽  
pp. 1-6
Author(s):  
Hua Bao ◽  
Hao-Ran Gao ◽  
Min-Lu Pan ◽  
Lei Zhao ◽  
Hai-Bin Sun
Keyword(s):  
Treatment Group ◽  
Cerebral Infarction ◽  
Early Stage ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction ◽  
Neurological Injury ◽  
Control Group ◽  
Efficacy And Safety ◽  
Time Period ◽  
And Control

BACKGROUND: Acute cerebral infarction (ACI) is a common cerebrovascular disease in clinical practice. OBJECTIVE: The present study aims to investigate the efficacy and safety of alteplase and urokinase in treating ACI. METHODS: A total of 96 patients with ACI, who were treated with alteplase and urokinase, were selected as the main subjects. Among these patients, 45 patients with ultra-early acute cerebral infarction, who received intravenous thrombolysis with RT-PA (alteplase), were included in the treatment group, while 51 patients with acute cerebral infarction, who were treated with urokinase in the same time period, were included in the control group. RESULTS: The National Institute of Health Stroke Scale (NIHSS) scores were significantly lower in the treatment group and control group (P< 0.05) at two hours, seven days and 14 days after thrombolysis, when compared to those before thrombolysis. The bleeding rate was significantly lower in the control group, when compared to the treatment group (P< 0.05). CONCLUSION: The intravenous thrombolysis with urokinase or alteplase in the ultra-early stage of acute cerebral infarction can reduce the neurological injury symptoms and effectively improve the prognosis of patients with stroke. Urokinase is lower in risk of bleeding, but better in safety, when compared to alteplase.

scholarly journals Comparative study of intravenous thrombolysis with rt-PA and urokinase for patients with acute cerebral infarction

2020 ◽  
Vol 48 (5) ◽  
pp. 030006051989535
Author(s):  
Fan Sun ◽  
Heng Liu ◽  
Hui-xiao Fu ◽  
Shuo Zhang ◽  
Xu-dong Qian ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Time Window ◽  
Intravenous Thrombolysis ◽  
Cerebral Haemorrhage ◽  
Recombinant Tissue Plasminogen Activator ◽  
Serum Levels ◽  
Acute Cerebral Infarction ◽  
Bleeding Complications ◽  
Therapeutic Effects ◽  
Clinical Trial Evidence

Objective Cerebral infarction has a poor prognosis and causes a serious burden on families and society. Recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) are commonly used thrombolytic agents in the clinic. However, direct and powerful clinical trial evidence to determine the therapeutic effect of rt-PA and UK on intravenous thrombolysis is lacking. Methods In this study, 180 patients with acute cerebral infarction were treated with rt-PA or UK. The National Institutes of Health Stroke Scale (NIHSS) scores, Barthel index, bleeding complications, and biomarkers were evaluated. Results No significant differences in NIHSS or Barthel scores were found between the groups. However, UK increased the risk of intracranial haemorrhage compared with rt-PA. rt-PA had increased activity in reducing serum levels of MMP-9 than UK. Conclusion Intravenous thrombolysis with rt-PA and UK in the time window of acute cerebral infarction can achieve similar therapeutic effects, but rt-PA can further reduce the risk of cerebral haemorrhage and is relatively safer than UK.

scholarly journals Meta-Analysis of the Effectiveness and Safety of Intravenous Thrombolysis in Patients with Acute Cerebral Infarction

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Huili Wu ◽  
Weiping Gong ◽  
Yanyan Tang ◽  
Wuhua Xu ◽  
Ying Zhou ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Meta Analysis ◽  
Grey Literature ◽  
Case Series ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction ◽  
Minor Bleeding ◽  
Randomized Controlled ◽  
The Difference ◽  
Better Than

In this paper, a meta-analysis of the effectiveness and safety of intravenous thrombolysis in patients with acute cerebral infarction was carried out, the original literature inclusion criteria and retrieval strategies were developed, and the collection deadline was about new oral anticoagulants and other methods for the antithrombotic intravenous thrombolytic treatment of patients with acute cerebral infarction for the relevant literature on the safety and effectiveness comparison. First, the quality of the literature is evaluated according to whether the included studies are randomized controlled trials, whether there is randomized concealment, whether blinding is used, and whether they are withdrawn or lost to follow-up, and the RevMan 5.2 software is used for meta-analysis. At the same time, grey literature databases such as dissertations were experimentally searched, and all randomized controlled studies (RCT), nonrandomized controlled studies, case-controlled studies, cohort studies, case series reports, etc. of Wingspan in the treatment of intracranial atherosclerotic stenosis were collected. In the prevention of myocardial infarction in patients with acute cerebral infarction, the difference between the two was not statistically significant ( RR = 0.82 , 95% CI (0.57, 1.17), P = 0.27 ). Compared with other methods, it can significantly reduce the all-cause mortality of patients with nonvalvular venous thrombolysis, and the difference is statistically significant ( RR = 0.90 , 95% CI (0.85, 0.96), P = 0.001 ). Experimental results show that in terms of safety, the new oral anticoagulant is better than other methods in reducing minor bleeding in patients with acute cerebral infarction, and the difference is statistically significant ( RR = 0.87 , 95% CI (0.76, 0 99), P = 0.03 ); the effect is better than other methods in reducing the incidence of serious bleeding events, and the difference is statistically significant ( RR = 0.79 , 95% CI (0.74, 0.85), P < 0.00001 ).

scholarly journals Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Xiaoying Liu ◽  
Shengli Rao ◽  
Jiajia Wang
Keyword(s):  
Cerebral Infarction ◽  
Conventional Treatment ◽  
Mild Hypothermia ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Nihss Score ◽  
Time Points ◽  
Before And After

Objective: To investigate the efficacy of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction. Methods: One hundred and thirty-two patients with acute cerebral infarction who were admitted to our hospital were selected and grouped into a control group and an observation group, 66 each group. Patients in the control group were given conventional treatment in combination with local mild hypothermia therapy, and patients in the observation group were given rt-PA intravenous thrombolysis on the basis of conventional treatment and local mild hypothermia therapy. National institute of health stroke scale (NIHSS) score and intracranial pressure (ICP) of the two groups before and after treatment was recorded. The efficacy of the two groups was evaluated. The modified Rankin scale (MRS) score was followed up for three months. The blood samples of the patients were collected before and after thrombolysis. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in the plasma were detected. Results: The NIHSS score of the two groups decreased in the 1st, 3rd and 7th day after treatment compared to before treatment (p<0.05), but the NIHSS score of the two groups had no significant difference at different time points after treatment (p>0.05). The ICP of the two groups decreased in the 1st, 3rd and 7th day after treatment compared to before treatment (p<0.05), and the decrease of ICP of the observation group was more significant than that of the control group at the same time point (1st, 3rd and 7th day after treatment) (p<0.05). The clinical efficacy of the observation group was higher than that of the control group after treatment, and the difference was statistically significant (p<0.05). The MDA concentration of both groups decreased at different time points after treatment (p<0.05), but the SOD concentration increased (p<0.05). The MDA concentration of the observation group was lower than that of the control group at different time points after treatment (p<0.05), and the SOD concentration of the observation group was higher than that of the control group (p<0.05). Conclusion: rt-PA intravenous thrombolysis in combination with mild hypothermia therapy has significant efficacy in the treatment of acute cerebral infarction. It can effectively relieve neurological function. Its action mechanism may be realized by relieving oxidative stress response. doi: https://doi.org/10.12669/pjms.35.4.311 How to cite this:Liu X, Rao S, Wang J. Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction. Pak J Med Sci. 2019;35(4):1161-1166. doi: https://doi.org/10.12669/pjms.35.4.311 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effects of Intravenous Thrombolytic Therapy with Alteplase on Neurological Function, Coagulation Function and Serum Inflammatory Factors in Patients with Acute Cerebral Infarction

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Xianfang Yue ◽  
Hua Zhou
Keyword(s):  
Cerebral Infarction ◽  
Intravenous Thrombolysis ◽  
Neurological Function ◽  
Acute Cerebral Infarction ◽  
Inflammatory Factors ◽  
Control Group ◽  
Routine Treatment ◽  
Coagulation Function ◽  
Hs Crp ◽  
Thrombolysis Therapy

Objective: To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function, coagulation function and serum inflammatory factors in patients with acute cerebral infarction. Methods: A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups, with 48 patients in each group. The control group (n=48) received routine treatment, and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment. The neurological deficit score, prothrombin time(PT), activated partial thromboplastin time (APTT), tumor necrosis factor-a level (TNF-?), and high-sensitivity C-reactive protein (hs-CRP) were compared between the two groups after 15 days of treatment. Results: After treatment, NIHSS scores in both groups were lower than those before treatment; PT levels were increased, while APTT, TNF-? and hs-CRP levels were all decreased in both groups, and the changes in the observation group were greater than those in the control group, with statistically significant difference (P<0.05). Conclusions: Intravenous thrombolysis therapy with alteplase can improve the neurological function, coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction, which is worthy of clinical application.

Sign in / Sign up

Export Citation Format

Share Document