Accuracy of self-perception of cardiovascular risk in the community.

Background: Assessment of individual risk is an important part of the primary prevention of coronary disease and stroke. The accuracy by which individuals perceive their risk is unclear. We aimed to explore the accuracy of self-perceived cardiovascular risk in the community, and the value of one-to-one interview, using a risk assessment tool, in increasing the accuracy.

Postprocedure intravenous eptifibatide following intra-arterial reteplase in patients with acute ischemic stroke.

Background And Purpose: Early use of intravenous platelet glycoprotein IIB/IIIA antagonists after intra-arterial (IA) thrombolysis may reduce the risk of reocclusion and microvascular compromise.

Methods: We performed a retrospective study to determine the in-hospital outcomes using serial neurological evaluations and imaging among patients treated with intravenous eptifibatide administered as a 135 microg/kg single-dose bolus, followed by 0.5 microg/kg/min infusions for 20 to 24 hours following treatment with IA reteplase.

Prehospital neurologic deterioration in patients with intracerebral hemorrhage.

Objective: Early neurologic deterioration has been studied in patients with intracerebral hemorrhage during hospitalization, but rates and factors associated with prehospital neurologic deterioration (PND) are unknown. We sought to determine the prevalence of PND among patients with intracerebral hemorrhage during Emergency Medical Services transportation to the hospital.

Design: Historical cohort study.

Changes in serum calcium levels associated with catheter-based cerebral angiography.

Background And Objective: Digital subtraction angiography is performed with agents such as iodinated contrast and intravenous heparin, which can alter electrolyte levels. If severe enough, these alterations may produce symptoms in patients in the post-procedural period. We performed this study to evaluate serum calcium level changes after cerebral angiography.

Mechanical disruption of thrombus following intravenous tissue plasminogen activator for ischemic stroke.

Background And Purpose: We prospectively evaluated the safety of aggressive mechanical disruption of thrombus following full-dose intravenous (IV) recombinant tissue plasminogen activator (rt-PA) to treat ischemic stroke in 24 patients with an initial National Institutes of Health stroke scale (NIHSS) score of >or=10.

Methods: Clinical evaluations were performed at presentation and 24 hours, 7 to 10 days, and 1 to 3 months (using modified Rankin scale) after treatment. These end points were compared to matched historical controls treated with IV rt-PA alone.

Early and intermediate-term outcomes with drug-eluting stents in high-risk patients with symptomatic intracranial stenosis.

Objective: To report the 1-month and intermediate-term results of treatment of symptomatic intracranial stenosis using drug-eluting stents.

Background: Patients with intracranial stenosis who are at high risk because of either high-grade stenosis or medication failure may have an annual risk of recurrent ischemic events in excess of 40%. Drug-eluting stents may reduce the rate of ischemic events in patients with a low restenosis rate.

Intra-arterial reteplase and intravenous abciximab in patients with acute ischemic stroke: an open-label, dose-ranging, phase I study.

Objective: New approaches are focusing on using a combination of medication that lyse fibrin and prevent aggregation of platelets to achieve higher rates of recanalization and improved clinical outcomes.

Methods: A prospective, nonrandomized, open-label trial evaluated the safety of an escalating dose of reteplase in conjunction with intravenous abciximab (platelet glycoprotein IIb/IIIa inhibitor) in patients with acute ischemic stroke (3-6 h after symptom onset). The primary endpoint was symptomatic intracerebral hemorrhage at 24 to 72 hours, and secondary endpoints were partial or complete recanalization (> or = one grade improvement), early neurological improvement (decrease in National Institutes of Health Stroke Scale > or = 4 at 24 h), and favorable outcome at 1 month (defined by modified Rankin scale < or = 2).

International classification of diseases and current procedural terminology codes underestimated thrombolytic use for ischemic stroke.

Background And Objective: To determine the accuracy of recently introduced International Classification of Diseases Ninth Revision (ICD-9) procedure and Current Procedural Terminology (CPT) codes designed for injection or infusion of thrombolytic agents.

Materials And Methods: We determined the accuracy of ICD-9 procedure code 99.10 and CPT codes 37201, 37202 for use of thrombolysis in ischemic stroke by comparing procedure codes of University Hospital discharge data with a concurrent prospective registry.

Treatment of acute hypertension in patients with intracerebral hemorrhage using American Heart Association guidelines.

Objective: To determine the feasibility and safety of treatment of acute hypertension in patients with intracerebral hemorrhage within 24 hrs of symptom onset. Elevated blood pressure, observed in up to 56% of patients with intracerebral hemorrhage, may predispose to hematoma expansion; on the other hand, reduction of blood pressure may reduce hematoma expansion and subsequent death and disability.

Design: Single-center prospective registry supplemented by retrospective chart review.

Acute treatment for ischemic stroke in 2004.

The last decade witnessed significant and unprecedented advances in the treatment of acute ischemic stroke. Intravenous tissue plasminogen activator and defibrinogenating agent are both now approved by the Food and Drug Administration for treatment of acute ischemic stroke within 3 h of symptom onset. Trials involving intra-arterial thrombolysis have demonstrated clinical benefit in patients treated within 6 h of symptom onset.