Therapeutic thrombolysis in cerebral thromboembolism

Js, Meyer; Gilroy, John; Barnhart, Marion I.; Johnson, Jared

doi:10.1212/wnl.13.11.927

Cited by 130 publications

(37 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of anticoagulants and antiplatelet drugs over the (Atkin et al, 1964;Brooks et al, 1970;Clarke & Cliffton, 1960;Hass et al, 1966;Herndon et al, 1960;Larcan et al, 1977;Meyer et al, 1961;Sussman & Fitch, 1958). A further 93 patients entered into studies which were partly controlled but which could be criticised for a number of reasons Hanaway et al, 1976;Labauge et al, 1980;Malinovsky & Kovlov, 1979;Meyer et al, 1964). The total mortality in the uncontrolled patients was at least 26 out of 91 and in the controlled group at least 23 out of 93 actively treated patients.…”

Section: Haemodynamic and Vascular Mechanismsmentioning

confidence: 99%

Therapeutic interventions in acute stroke.

Lees

1992

Brit J Clinical Pharma

View full text Add to dashboard Cite

1. Potential therapies for ischaemic stroke include agents to reduce oedema, to improve cerebral perfusion, to reduce excitotoxic damage, to minimise free‐radical induced injury and to reduce complications such as deep venous thrombosis. 2. Of the anti‐oedema drugs, steroids are ineffective and possibly dangerous; intravenous glycerol is unproven. 3. Haemodilution to reduce whole blood viscosity and improve perfusion is ineffective. Thrombolytic drugs have not been adequately tested but several randomised multicentre trials are now commencing. Early treatment and CT scanning are essential. 4. Anticoagulants and antiplatelet drugs may have wide applicability but have not been tested in the acute phase of stroke. A multi‐centre trial will address this issue. 5. Neuronal cytoprotection offers exciting prospects for acute stroke treatment. Antagonists of glutamate at the NMDA receptor, calcium and sodium channel blocking agents and free radical scavenging drugs have potent effects experimentally. Several agents are now reaching clinical trials. The calcium antagonist nimodipine has been disappointing in large scale trials but some studies were flawed by late treatment. 6. Successful treatment of acute stroke is likely to combine several approaches. 7. Therapeutic trials in stroke must include CT scanning, early treatment and a multicentre approach to achieve large numbers of patients.

show abstract

Section: Haemodynamic and Vascular Mechanismsmentioning

confidence: 99%

Therapeutic interventions in acute stroke.

Lees

1992

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…T hrombolytic therapy for stroke was first reported in 1958 1 and a subsequent small trial was reported in 1963 2 in the absence of brain parenchymal imaging but guided by angiography. The later arrival of CT scanning was an enabling technological event, and early dose-finding trials were begun in the 1980s, [3][4][5] with large randomized trials conducted a decade later.…”

mentioning

confidence: 99%

Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study

Hill¹

2005

Canadian Medical Association Journal

418

284

View full text Add to dashboard Cite

show abstract

“…Most of the patients had angiographic evidence of thrombi resolution, but there was no significant improvement in the clinical outcome. 63 When the same group evaluated whether streptokinase and heparin could be given in progressive strokes within 72 hours of onset, they found that there was significantly worse outcomes with increased risk of ICH. 64 About 30 years later, streptokinase was used in multiple studies for myocardial infarction and was again looked at in the context of acute ischemic stroke; however, none of the trials, including the Multicenter Acute Stroke Trial-Europe (MAST-E), Multicenter Acute Stroke Trial-Italy (MAST-I), and the Australian Streptokinase study, were able to demonstrate a benefit for streptokinase administration versus placebo.…”

Section: Acute Stroke Treatments: Outcome Assessment In Thrombolysis mentioning

confidence: 99%

Evolving Treatments for Acute Ischemic Stroke

Zerna

Hegedus

Hill

2016

Circulation Research

View full text Add to dashboard Cite

Abstract:The purpose of this article is to review advances in stroke treatment in the hyperacute period. With recent evolutions of technology in the fields of imaging, thrombectomy devices, and emergency room workflow management, as well as improvement in statistical methods and study design, there have been ground breaking changes in the treatment of acute ischemic stroke. We describe how stroke presents as a clinical syndrome and how imaging as the most important biomarker will help differentiate between stroke subtypes and treatment eligibility. The evolution of hyperacute treatment has led to the current standard of care: intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation. All patients with acute ischemic stroke are in need of hyperacute secondary prevention because the risk of recurrence is highest closest to the index event. The dominant themes of modern stroke care are the use of neurovascular imaging and speed of diagnosis and treatment. (Circ Res.

show abstract

Therapeutic thrombolysis in cerebral thromboembolism

Cited by 130 publications

References 0 publications

Therapeutic interventions in acute stroke.

Therapeutic interventions in acute stroke.

Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study

Evolving Treatments for Acute Ischemic Stroke

Contact Info

Product

Resources

About