Publications by authors named "Bill O'Brien"
Article Synopsis
- A study found that using a higher dose of tenecteplase (0.40 mg/kg) for patients with ischemic stroke significantly improves blood flow before thrombectomy compared to a lower dose (0.25 mg/kg).
- Conducted as a randomized clinical trial across 27 hospitals in Australia and 1 in New Zealand, the research involved 300 patients who had large vessel occlusion strokes and were treated within 4.5 hours of symptom onset.
- Key results showed that a larger percentage of patients experienced more than 50% reperfusion of the affected area before undergoing thrombectomy, along with various outcomes related to disability
Aims: Penumbral selection is best-evidence practice for thrombectomy in the 6-24 hour window. Moreover, it helps to identify the best responders to thrombolysis. Multimodal computed tomography (mCT) at the primary centre-including noncontrast CT, CT perfusion, and CT angiography-may enhance reperfusion therapy decision-making.
View Article and Find Full Text PDFThe potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer's disease (AD) has been described previously. However, the role of Apolipoprotein E є4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female = 38; age = 76.
View Article and Find Full Text PDFPotential difficulty of distinguishing densely compacted thrombi from small calcific emboli.
J Med Imaging Radiat Oncol
December 2018
Introduction: Calcified cerebral emboli are an increasingly recognized cause of ischaemic stroke, although recognition amongst general radiologists and clinicians can be limited. Recent literature suggests that calcified cerebral emboli are likely more common than originally thought. This study aims to define the prevalence of calcified cerebral emboli as the most likely aetiology within a cohort of confirmed cases of acute stroke, as well as compare and contrast these cases with cases of 'incidental' intracranial calcification.
View Article and Find Full Text PDFBackground and hypothesis Intravenous thrombolysis with alteplase remains standard care prior to thrombectomy for eligible patients within 4.5 h of ischemic stroke onset. However, alteplase only succeeds in reperfusing large vessel arterial occlusion prior to thrombectomy in a minority of patients.
View Article and Find Full Text PDFStroke is a common neurological emergency and may occur in patients of all ages. Rapid assessment is crucial for patients with acute neurological symptoms suggestive of stroke because the opportunity for a positive outcome from thrombolytic treatment diminishes rapidly within the first few hours. Although plain non-contrast computed tomography of the brain is adequate to exclude haemorrhage and conditions such as malignancy, advanced multimodal imaging can be used to assist with decision making regarding the use of recombinant tissue plasminogen activator and mechanical clot-retrieval approaches without adding significant delay.
View Article and Find Full Text PDFBackground: Intravenous alteplase is the only approved treatment for acute ischemic stroke. Tenecteplase, a genetically engineered mutant tissue plasminogen activator, is an alternative thrombolytic agent.
Methods: In this phase 2B trial, we randomly assigned 75 patients to receive alteplase (0.