Intravenous thrombolysis in a stroke patient with a repaired aortic dissection.

Acute aortic dissection is considered a contraindication to the use of intravenous thrombolysis in patients presenting with acute ischaemic stroke, but less has been described about previously repaired dissections. We present a case of a woman in her 50s presenting with acute left hemiparesis with a known history of aortic dissection within the thrombolysis window. After multidisciplinary discussion with cardiothoracic surgery and discussion with the patient, she was treated with intravenous thrombolysis without complication.

Geographical differences in thrombolysis treatment for acute ischaemic stroke.

Background: Administering intravenous thrombolysis (IVT) as soon as possible after symptom onset impacts on the functional outcome for patients with acute ischaemic stroke. The study aimed to assess whether the distance from hospital impacts on the access to IVT for acute ischaemic stroke at the University Hospital of North Norway in Tromsø (UNN Tromsø).

Material And Method: This prospective quality study included 231 patients admitted with acute ischaemic stroke to UNN in the period 1 January 2019-31 December 2019.

[RIGHT HEART FAILURE PRESENTATION OF IDIOPATHIC MASSIVE PULMONARY EMBOLISM - CASE REPORT].

Massive pulmonary embolism (PE) is a life threatening condition with age-related escalation in prevalence. Acute PE is a common and sometimes fatal disease. The approach to the evaluation should be efficient while simultaneously avoiding the risks of unnecessary testing so that therapy can be promptly initiated and potential morbidity and mortality avoided.

The Effect of Acute Stroke Treatment on S100B, IMA, and Thiol-Disulfide Balance.

Background: A variety of processes, ranging from blood-brain barrier disruption to circulating biomarkers, contributes to reperfusion injury in acute stroke treatment.

Objective: We aimed to investigate the effects of thrombolytic therapy and endovascular thrombectomy therapy on serum S100 calcium-binding protein B, ischemia-modified albumin and thiol-disulfide balance in patients who arrived within the first 6 h of acute ischemic stroke.

Material And Methods: The study considered 66 patients with the diagnosis of acute ischemic stroke who underwent thrombolytic therapy or EVT in the first 6 h, as well as 32 healthy volunteers.

[Stroke: current state of the problem].

We review the current and emerging topics in ischemic stroke (IS) and intracerebral hemorrhage (ICH). We discuss the association of genetic predisposition and healthy lifestyle, ambient particulate air pollution, weather parameters, variations in the anatomy of cerebral blood vessels, psychological stress, depression, insonmia with the development of IS or ICH. Also, the role of oral anticoagulants (AC) as a new risk factor for ICH is presented.

Pharmaco-Invasive Strategy With Half-Dose Tenecteplase in Patients With STEMI: Prespecified Pooled Analysis of Patients Aged ≥75 Years in STREAM-1 and 2.

Background: In STREAM-1 (Strategic Reperfusion Early After Myocardial Infarction), excess intracranial hemorrhage occurred in patients aged ≥75 years receiving full-dose tenecteplase as part of a pharmaco-invasive strategy, whereas no further intracranial hemorrhage occurred after halving the tenecteplase dose. In STREAM-2 (Second Strategic Reperfusion Early After Myocardial Infarction), half-dose tenecteplase was an effective and safe pharmaco-invasive strategy in older patients with ST-segment-elevation myocardial infarction presenting within <3 hours, compared with primary percutaneous coronary intervention (PCI). We prespecified evaluating the efficacy and safety of a half-dose versus full-dose pharmaco-invasive strategy and compared the half-dose pharmaco-invasive strategy to primary PCI in patients aged ≥75 years.

Predictive factors for lack of neurological improvement in acute stroke patients without large vessel occlusion treated with low-dose thrombolysis and screened with 3T MRI.

Objective: The study evaluated the lack of neurological improvement and the factors influencing it in patients with acute ischemic stroke (AIS) without major arterial occlusion.

Patients And Methods: A cross-sectional study was conducted on patients diagnosed with acute ischemic stroke without significant occlusion of major arteries, with imaging evidence from 3-tesla magnetic resonance imaging (MRI) scans at the S.I.

Edaravone's Safety Profile in Acute Ischemic Stroke.

Background: We aimed to evaluate the safety of intravenous edaravone for the treatment of acute ischemic stroke among Filipino patients. The study, categorized as Phase IV, spans from December 2022 to November 2023. The primary objective is to document side effects and serious adverse events during the 14-day edaravone infusion period.

A Nattokinase-Loaded Nanozyme for Alleviating Acute Myocardial Infarction via Thrombolysis and Antioxidation.

Acute myocardial infarction (MI) induced by thrombus formation is a prevalent cardiovascular disorder, and thrombolytic therapy continues to be a principal treatment modality. Prior research indicates a substantial association among MI, thrombosis, and the activation of oxidative stress pathways. The effectiveness of current thrombolytic drugs is relatively constrained, and the need for innovative and versatile thrombolytic medications remains critical.

New targets for antithrombotic medications: seeking to decouple thrombosis from hemostasis.

Arterial and venous thromboses are the leading causes of morbidity and mortality worldwide. Numerous antithrombotic agents are currently available with antiplatelet, thrombolytic/fibrinolytic, and anticoagulant activity. However, all the currently available antithrombotic agents carry a risk of bleeding that often prevents their use.

Endovascular therapy for acute vertebrobasilar occlusion (VERITAS): a systematic review and individual patient data meta-analysis.

Background: Trials of endovascular therapy for basilar artery occlusion, including vertebral occlusion extending into the basilar artery, have shown inconsistent results. We aimed to pool data to estimate safety and efficacy and to explore the benefit across pre-specified subgroups through individual patient data meta-analysis.

Methods: VERITAS was a systematic review and meta-analysis that pooled patient-level data from trials that recruited patients with vertebrobasilar ischaemic stroke who were randomly assigned to treatment with either endovascular therapy or standard medical treatment alone.

Frailty reduces penumbral volumes and attenuates treatment response in hyperacute ischemic stroke.

Background: Frailty-the loss of physiological reserve to withstand a stressor event-is associated with poorer outcomes following acute stroke reperfusion therapies. However, the mechanisms underlying this relationship are poorly understood. This study investigated the association between frailty and penumbral volumes in hyperacute ischemic stroke.

Chinese Stroke Association guidelines on emergency stroke unit.

Organised stroke care has become a keystone in delivering efficient and effective treatment to patients with stroke with improved outcomes. Delivering timely acute reperfusion therapy to those with acute ischaemic strokes is key to good recovery. Emergency stroke unit (ESU) is a novel organised stroke care system developed in China.

The role of nanomaterials in revolutionizing ischemic stroke treatment: Current trends and future prospects.

Ischemic stroke has a high disability rate, which leads to irreversible neuronal death. The efficacy of conventional stroke treatments, including thrombolytic and neuroprotective therapies, is constrained by a number of factors, including safety concerns and inefficient drug delivery. The advent of nanomaterials has created new avenues for stroke therapy, facilitating enhanced pharmacokinetic behavior of drugs, effective drug accumulation at the target site, augmented therapeutic efficacy, and concomitant reduction in side effects.

The Joint Effect of Renal Function Status and Coagulation Biomarkers on In-Hospital Outcomes in Acute Ischemic Stroke Patients With Intravenous Thrombolysis.

Objective: To demonstrate whether combining renal function status [estimating glomerular filtration rate (eGFR)] with coagulation biomarkers [fibrinogen (Fg) and d-dimer] is more beneficial in predicting in-hospital outcomes following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients.

Methods: We studied 417 AIS patients with IVT. According to the cut-offs of coagulation biomarkers (Fg and d-dimer) and eGFR determined by receiver operating characteristic (ROC) curves, the patients were divided into four groups: LFLG (low Fg and low eGFR), LFHG (low Fg and high eGFR), HFLG (high Fg and low eGFR), and HFHG (high Fg and high eGFR); or LDLG (low d-dimer and low eGFR), LDHG (low d-dimer and high eGFR), HDLG (high d-dimer and low eGFR), and HDHG (high d-dimer and high eGFR).

Development and implementation of an emergency alteplase kit for high-risk pulmonary embolism in cardiac arrest.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

[Analysis of the emergency standard ischemic stroke care system time points for in-hospital-onset ischemic stroke and community-onset stroke in general hospital].

To analyze the treatment situation at each time node in the standard in-hospital-stroke(IHS) in the general hospital compared with that in the emergency(community)-onset stroke (COS) group. A single-center retrospective case-control study was performed.The clinical cases of acute COS group and IHS group who were treated by the same stroke green channel team at Peking Union Medical College Hospital from Jan.

The stroke meta-metric, Defect-Free Care, was maintained year-over-year within the Florida stroke registry during the COVID-19 pandemic.

Background: Resource allocation for stroke care was impacted worldwide by the Coronavirus 2019 (COVID19) pandemic. Regionally, worsened stroke outcomes varied, however comparative year-over-year in-hospital performance metrics from the pandemic are unreported. Therefore, within the large Florida Stroke Registry (FSR), we assessed the pandemic's effects upon the American Heart Association (AHA) Get With The Guidelines (GWTG) ischemic stroke metrics and the meta-metric, Defect-Free Care (DFC).

Res@LDH: A Novel Nanohybrid Therapeutic for Ischemia-Reperfusion Injury with Dual Reactive Oxygen Species Scavenging Efficiency.

Ischemic stroke poses a global health challenge, necessitating effective therapeutic interventions given the limited time window for thrombolytic therapy. Here, we present Res@LDH, a novel nanohybrid therapeutic agent boasting a dual reactive oxygen species scavenging efficiency of approximately 90%. Comprising Ge-containing layered double hydroxide nanosheets (Ge-LDH) as a drug nanocarrier and resveratrol as a neuroprotective agent, Res@LDH demonstrates enhanced permeability across the blood-brain barrier, ensuring high biocompatibility and stability.

OUTCOME OF PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION (STEMI) BASED ON ADMISSION SERUM POTASSIUM LEVEL.

Background: Potassium levels play a significant role in cardiovascular patients, with hypokalemia and hyperkalemia having profound effects on the mortality rate. The aim of this study was to investigate the correlation of admission serum potassium levels and in-hospital mortality in patients suffering from acute ST-elevation myocardial infarction (STEMI).

Methods: The study was conducted in the Department of Cardiology, Ayub Teaching Hospital Abbottabad, and involved 225 patients with STEMI who underwent thrombolysis with streptokinase.

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia.

Hemorrhagic transformation (HT) is a serious complication that can occur as a result of thrombolytic therapy following ischemic stroke (IS), and it poses significant limitations on the clinical application of recombinant tissue plasminogen activator (rt-PA). Unfortunately, there are currently no effective interventions available for HT in clinical practice. Therefore, there is an urgent need for stable and reliable experimental animal models to elucidate the pathogenesis of HT and develop effective intervention strategies.