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Antiplatelets before or during endovascular therapy after intravenous thrombolysis for atherothrombotic large vessel occlusion.
J Clin Neurosci
December 2024
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan; Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Re-occlusion and intravascular thrombus formation following mechanical thrombectomy (MT) in stroke patients worsen clinical outcomes. Although early administration of antiplatelet therapy (APT) prevents these complications, current guidelines advise against using APT soon after intravenous thrombolysis (IVT), making the management of atherothrombotic large vessel occlusion (AT-LVO) difficult. We investigated the safety of early APT for acute AT-LVO treated with MT following IVT.
View Article and Find Full Text PDFA randomized trial of low-dose thrombolysis, ultrasound-assisted thrombolysis, or heparin for intermediate-high risk pulmonary embolism-the STRATIFY trial: design and statistical analysis plan.
Trials
December 2024
Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Background: Intermediate-high risk pulmonary embolism (PE) carries a significant risk of hemodynamic deterioration or death. Treatment should balance efficacy in reducing clot burden with the risk of complications, particularly bleeding. Previous studies on high-dose, short-term thrombolysis with alteplase (rtPA) showed a reduced risk of hemodynamic deterioration but no change in mortality and increased bleeding complications.
View Article and Find Full Text PDFEarly neurological deterioration in acute ischemic minor stroke patients with large vessel occlusion following intravenous thrombolysis.
World Neurosurg
December 2024
Department of Neurology, Nanjing Pukou People's Hospital, No. 166 Shanghe Street, Jiangpu Subdistrict, Pukou District, Nanjing, 210000, China. Electronic address:
Objective: Early identification of risk factors associated with early neurological deterioration (END) in patients with acute minor stroke and large vessel occlusion (LVO) receiving intravenous thrombolysis (IVT) could assist in formulating treatment decisions.
Methods: Consecutive patients with acute minor stroke and LVO were extracted from a single-center prospective database spanning January 2020 to December 2023. END was defined as an increase of ≥ 4 points in the National Institutes of Health Stroke Scale (NIHSS) score from baseline, or ≥ 2 points in any single NIHSS item, within 24 hours of the IVT.
Pretreatment Cranial Computed Tomography Perfusion Predicts Dynamic Cerebral Autoregulation Changes in Acute Hemispheric Stroke Patients Having Undergone Recanalizing Therapy: A Retrospective Study.
Neurol Int
November 2024
Department of Radiology, Section Neuroradiology, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
Objectives: Blood pressure (BP) management is challenging in patients with acute ischemic supratentorial stroke undergoing recanalization therapy due to the lack of established guidelines. Assessing dynamic cerebral autoregulation (dCA) may address this need, as it is a bedside technique that evaluates the transfer function phase in the very low-frequency (VLF) range (0.02-0.
View Article and Find Full Text PDFOutcomes and Complications Associated with Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke.
Cardiol Cardiovasc Med
December 2024
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
Universally, stroke presents as neurological deficits due to the obstruction of blood supply to specific regions of the brain. Among the three main categories of stroke, acute ischemic stroke is the leading cause of death and disability worldwide. As of today, there are two effective treatment methods: thrombolysis and endovascular therapy.
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