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Findings from the highly-anticipated MOST (Multi-Arm Optimization of Stroke Thrombolysis) trial were presented on the first day of the American Stroke Association’s International Stroke Conference, ISC 2024, being held through Feb. The study was looking for improvement in functional outcomes at 90 days. 9 Phoenix, AZ. Adeoye, M.D.,
BACKGROUND:Timely intravenous thrombolysis and endovascular thrombectomy are the standard reperfusion treatments for large vessel occlusion stroke. METHODS:We enrolled consecutive patients in the multicenter Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke who had received combined thrombolysis (within 4.5
BACKGROUND:The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. Primary outcome was a shift toward better functional outcome on the modified Rankin Scale at 90 days. Stroke, Ahead of Print.
2. Expand and invest in infrastructures for essential stroke services, including stroke units and intravenous thrombolysis.* 5. For example, an average of around 7 percent of all ischemic stroke patients in the Europe region received this treatment in 2019. 4. Increase the necessary skills in the health workforce.
Background:Stroke patients with limited English proficiency (LEP) in the United States have limited stroke recovery and reduced post-stroke neurological care.Objective:Identify 90-day stroke outcomes using the modified Rankin Score (mRS) for patients discharged from Methodist Hospital with LEP. There were 55 identified as LEP.
Introduction:Recent studies report similar outcomes with antiplatelet drugs and intravenous thrombolysis (IVT) in patients with minor nondisabling ischemic stroke. Stroke, Volume 55, Issue Suppl_1 , Page ATMP13-ATMP13, February 1, 2024. Patients were excluded if they were on anticoagulation, presented beyond 4.5
However, limited studies have compared their clinical features and outcomes. National Inpatient Sample (2005-2019) using ICD-9 and ICD-10 codes. Within the concurrent AIS group, the CCAD group also exhibited an increased likelihood for IV thrombolysis (10.7% vs. 8.7%), atrial fibrillation (6.1% vs. 3.7%), hypertension (58.0%
Introduction:The rapid advancement of artificial intelligence (AI) technologies holds promise for improving healthcare outcomes. The study focused on adult patients (18 years or older) admitted to Alexian Brothers Medical Center in Illinois between 2019-2022 who were diagnosed with acute ischemic stroke.
We aimed to examine the impact of dexmedetomidine on outcomes in patients with anterior circulation large vessel occlusion (acLVO) requiring neurocritical care after endovascular therapy (EVT).Methods:We While favorable functional outcome was less frequently observed in the dexmedetomidine than in the comparator group (7.9%
Pre-transfer variables independently associated with clinical improvement were intravenous thrombolysis use, more distal occlusions, and lower serum glucose; variables associated with deterioration included more proximal occlusions and higher serum glucose.
Introduction:Tenecteplase (TNK) is increasingly being utilized for IV thrombolysis in acute ischemic stroke, including for patients with large vessel occlusion (LVO) prior to transfer to an endovascular thrombectomy (EVT) capable center (TCC). The primary outcome was a favorable 90-day mRS of 0-2. TNK vs. 48.4% no TNK, p=0.35).
In this context, we need a movement to revive the pre-hospital thrombolysis. best, It has a miniscule 1 % edge in the outcome if performed on time, at a expertise intensive place. Efficiency of thrombolysis is highly reproducible. Circulation 2006;114:2019-25 This is what CAPTIM told us. DOI: 10.4103/rcm.rcm_1_24 2.Nallamothu
We sought to evaluate the spoke hospital door in-door out (DIDO) times for patients transferred to our hub center for EVT.Methods:Individuals who first presented with LVO to a spoke hospital and were then transferred to the hub for EVT were retrospectively identified from a prospectively maintained database from January 2019 to November 2022.
We sought to evaluate the spoke hospital door in‐door out (DIDO) times for patients transferred to our hub center for EVT.MethodsIndividuals who first presented with LVO to a spoke hospital and were then transferred to the hub for EVT were retrospectively identified from a prospectively maintained database from January 2019 to November 2022.
Introduction:In large vessel occlusion (LVO) ischemic stroke patients, better functional outcomes are associated with achieving modified thrombolysis in cerebral infarction (mTICI) score 2C/3 in comparison to 2B. Primary outcome measure was achieving mTICI 2C/3 (i.e., excellent) revascularization. were female.
BackgroundPrevious clinical trials found improved outcome of thrombolytic treatment in patients with ischemic wake‐up stroke (WUS) selected by advanced imaging techniques. Functional outcomes were assessed by the modified Rankin Scale (mRS) at 3 months. Journal of the American Heart Association, Ahead of Print. 1.74];P=0.050).
Detailed clinical, laboratory and multimodal imaging data from known AF patients consecutively admitted to 20 stroke centers with an IS between 1/2018-12/2019 were used to define characteristics of AIS-despite-AC and compared to AIS-off-AC.Results:Out of 4456 patients with known AF prior to the AIS, 2051 (46%) were using anticoagulants.
Introduction:Significant strides have been made in optimizing thrombolysis and thrombectomy for acute ischemic stroke treatment. However, available treatment options and better patient outcomes favor stroke patients with hospital arrivals within earlier time frames relative to symptom onset.
Patients with acute ischemic stroke aged between 18 and 80 years who were eligible for standard intravenous thrombolysis were enrolled from 17 centers in China and randomly assigned (1:1:1) to receive intravenous reteplase 12+12 mg, intravenous reteplase 18+18 mg, or intravenous alteplase 0.9 Four patients did not receive the study agent.
For inclusion, patients must have been successfully recanalized by mechanical thrombectomy with or without intravenous thrombolytic and ultimate modified thrombolysis in cerebral infarction (mTICI) score 2B/2C/3. Occurrence of HT was determined from post-interventional imaging, and HT subtype was defined by the ECASS 2 criteria.
BackgroundSoutheast Asia accounts for approximately 10% of stroke‐related mortalities worldwide, yet there are limited data regarding mechanical thrombectomy (MT) outcomes in this region. The primary end point was functional independence (modified Rankin scale 0–2) at 90 days. Most patients were discharged to home by 90 days (84.1%, 154/183).ConclusionPROSPR‐SEA
IntroductionCurrent literature suggests a benefit in functional outcomes and reperfusion rates when carotid artery stenting (CAS) and mechanical thrombectomy (MT) are performed emergently. Good clinical outcomes were a < 4 points of NIHSS at 24 hours, mRS (0‐3) at 90 days, and disposition to home or inpatient rehabilitation.
There was no difference in pre-stroke modified Rankin scale (mRS), NIHSS on admission, mortality, discharge mRS, or 90-day mRS between these two groups, nor between patients who received intravenous thrombolysis (IVT) vs. those who did not. p=0.028), discharge mRS (1.3 p=0.009), and 90-day mRS (1.0 p=0.038) than those who did not.
Large vessel occlusion (LVO), a quarter of ischemic strokes, portends poor outcomes. Patients with LVO residing in RAs more likely transferred into hospitals from other facilities than arrived from scene, less likely received thrombolysis, and had higher onset-to-arrival time.
BACKGROUNDIn patients with acute ischemic stroke secondary to large vessel occlusion, achieving modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3 (excellent recanalization) over mTICI 2b is associated with improved functional outcomes. Stroke: Vascular and Interventional Neurology, Ahead of Print. P=0.012).
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. Am J Med 2019, 132(5):622-630. American Journal of Medicine 132(5):622-630; May 2019.
The TIMI (Thrombolysis in Myocardial Infarction) Study Group is a Division of Cardiovascular Medicine at the esteemed Brigham and Women’s Hospital and Harvard Medical School. Trials of this size are complex and can’t be done by just anyone, which is why the famed TIMI group was tasked with the job.
BACKGROUND:There is limited information on the delivery of acute stroke therapies and secondary preventive measures and clinical outcomes over time in young adults with acute ischemic stroke. The observation period was divided into 4 epochs: 2008 to 2010, 2011 to 2013, 2014 to 2016, and 2017 to 2019. men, 71.9%) were registered.
This study explores the interaction between structural racism, urbanity, and the administration of acute ischemic stroke (AIS) interventionsspecifically, intravenous thrombolysis (TPA) and endovascular thrombectomy (ET).Methods:This These findings suggest a need for targeted interventions to address these inequities in stroke treatment
In this post hoc analysis, baseline characteristics, workflow times, successful reperfusion (extended Thrombolysis in Cerebral Infarction score ≥2b), symptomatic intracerebral hemorrhage, 90-day functional independence (modified Rankin Scale score, 0–1), and 90-day mortality were compared by sex. mg/kg) with alteplase (0.9 hours of onset.
08/11, 12:07] Dr S Venkatesan: Is the therapeutic time window for primary PCI and thrombolysis same ? [08/11, Thrombolysis has a broader time window, but efficacy decreases significantly after 6 hours. [ Thrombolysis has a broader time window, but efficacy decreases significantly after 6 hours. [ How can they be different? [08/11,
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