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Orhan Ahmet L - - 2009
AIMS: The aim of this study was to evaluate the relationship between homocysteine levels and the development of left ventricular thrombus in acute anterior myocardial infarction patients directed to thrombolytic therapy. METHODS AND RESULTS: Seventy-nine patients presenting with ST elevated acute anterior myocardial infarction and treated with thrombolytic agent, t-PA, ...
Melandri Giovanni - - 2009
TNKase is a genetically engineered variant of the alteplase molecule. Three different mutations result in an increase of the plasma half-life, of the resistance to plasminogen-activator inhibitor 1 and of the thrombolytic potency against platelet-rich thrombi. Among available agents in clinical practice, TNKase is the most fibrin-specific molecule and can ...
Brouns Raf - - 2009
INTRODUCTION: Thrombolytic therapy improves clinical outcome in patients with acute ischemic stroke but is compromised by symptomatic intracranial hemorrhage and an unpredictable therapeutic response. In vitro and in vivo data suggest that activation of procarboxypeptidase U (proCPU) inhibits fibrinolysis. AIMS: To investigate whether the extent of proCPU activation is related ...
Provenzale James M - - 2008
The use of thrombolytic agents and other forms of reperfusion therapy has provided a means to reverse ischemia and minimize the size of infarctions. The purpose of this review is to examine various clinical trials of reperfusion agents and address key imaging issues. Advanced MRI and CT play a growing ...
Keeble William - - 2008
Contrast-enhanced cardiac magnetic resonance imaging can define the territory and extent of myocardial infarction from patterns of late gadolinium enhancement. Following failure to reperfuse with thrombolytic therapy, a case of myocardial infarction is described in which ongoing symptoms and an electrocardiogram change led to a diagnostic dilemma. Cardiac magnetic resonance ...
Dogan Mehmet - - 2009
Coronary embolism is an uncommon cause for myocardial infarction in clinical practice and there is no consensus on the treatment of this subject. Thrombolytic agents and percutaneous intervention are up to date options and yet there are only a few case reports regarding thrombolytic therapy in this special subgroup of ...
Finelli Pasquale F - - 2008
BACKGROUND: The role of neuroimaging in acute posterior cerebral artery (PCA) territory infarction is less well appreciated compared with the anterior cerebral circulation because PCA infarction occurs less frequently and more often is associated with limited neurologic deficit not qualifying for thrombolytic therapy. On occasion, however, hemiparesis and/or visual field ...
Sharma Samin K - - 2008
Over 20 years have passed since the introduction of the tri-iodinated low-osmolar nonionic contrast agents such as iopamidol, iohexol, ioversol and iopromide. During this time, most cardiology practices have switched to these nonionic agents to avoid the nuisance side effects and cardiac adverse events associated with the older ionic contrast ...
Cheung N W - - 2008
Hyperglycaemia in the period following myocardial infarction is associated with increased mortality and there is some evidence that its treatment can improve survival. However, it remains unclear as to what the ideal glucose targets might be. This study examined observational data taken from a previously reported randomised controlled trial of ...
Kimura Kazumi - - 2008
BACKGROUND AND PURPOSE: Intravenous administration of tissue plasminogen activator (t-PA) can improve clinical outcomes in patients with acute ischemic stroke. The most important complication of t-PA therapy is intracerebral hemorrhage (ICH). The aim of this study was to use serial MRI studies to identify independent predictors of symptomatic and asymptomatic ...
Vincze Z - - 2008
Thrombolytic agents activate plasminogen and induce a systemic fibrinolytic and anticoagulant state. Two thrombolytic drugs are used frequently in practice: streptokinase (SK) and alteplase (t-PA). Streptokinase mainly undergoes renal elimination with a half-life of 11-17 min, while alteplase is eliminating by the liver with a half-life of 4-6 min. Our ...
Webb Ian - - 2008
Myocardial infarction remains a major cause of death despite contemporary therapeutic strategies. Diagnosis in the intensive care unit is challenging, but is essential to target therapy accurately. In this issue of Critical Care Lim and colleagues present the results of a prospective non-interventional screening study for acute myocardial infarction in ...
Taylor Carolyn W CW Clinical Trial Service Unit, Oxford University, Oxford, United Kingdom. - - 2007
To estimate the doses to the heart and coronary arteries from common breast cancer radiotherapy (RT) regimens used worldwide from the 1950s to the 1990s. Virtual simulation and computed tomography planning were used to reconstruct the megavoltage and electron regimens. Manual planning was used for the orthovoltage and brachytherapy regimens. ...
Diatchuk Valery - - 2007
A 60-year-old man experienced right orbital pain, periorbital swelling, and double vision 2 hours after treatment with streptokinase and heparin for myocardial infarction. Orbital CT revealed a right superior subperiosteal orbital hemorrhage. Conservative management in the absence of visual compromise was sufficient, as his symptoms and signs resolved completely in ...
Hilleman Daniel E - - 2007
Rapid reperfusion is the key treatment goal in patients with ST-segment elevation myocardial infarction (STEMI). The American College of Cardiology-American Heart Association (ACC-AHA) 2004 guidelines for the management of STEMI include recommendations for pharmacologic reperfusion with use of fibrinolytic agents. Fibrinolytic agents are the preferred pharmacologic class for the management ...
Nyquist Paul - - 2007
Intraventricular hemorrhage (IVH) may occur as an isolated event from primary ventricular bleeding or as a complication of brain hemorrhage from another etiology. It is associated with high mortality and morbidity. Recent translational and clinical studies demonstrate that thrombolytic drugs administered intraventricularly through an external ventricular drain to lyse an ...
Fayomi O - - 2007
Myocardial infarction in pregnancy is uncommon. Use of thrombolytic treatment is relatively contraindicated. Early recognition as well as a multidisciplinary approach to the management of these cases is important, as untreated there is a high maternal and fetal mortality. The case presented here highlights the importance of early transfer to ...
Dickinson C J - - 2007
Much evidence suggests that acute intracerebral haemorrhage usually starts to appear an hour or two after a thromboembolic brain infarct. Intravenous thrombolytic treatment is accepted treatment for acute ischaemic stroke; but all neurologists concur that brain imaging should be performed first, so that thrombolysis can be avoided if bleeding has ...
Al-Khawaja Darweesh - - 2007
Intracerebral hemorrhage (ICH) after thrombolytic treatment for acute myocardial infarction (AMI) is a serious complication causing significant morbidity and mortality. Drainage of the haematoma by craniotomy is associated with poor outcome. We present a patient who received tissue plasminogen activator (t-PA) for acute myocardial infarction; he subsequently developed an ICH ...
Kiki, ─░lhami
Aim: Von Willebrand Factor is a glycoprotein, which plays role in primary hemostasis, mainly acts getting platelets to adhere onto the subendothelial tissue and carrying Factor VIII. Although vWF deficient animals had been shown to be resistant to atherosclerosis and thrombotic events, it had not been proven in humans. In ...
Kiernan Thomas J - - 2007
ST-segment elevation myocardial infarction (STEMI) is still a major public health problem in the modern world. Therapeutic options have changed much over the last 20 years, with a shift in favor of mechanical reperfusion over pharmacologic reperfusion. Thrombolytic therapy still has much to offer in the management of STEMI, however, ...
Chen Jack P - - 2007
With today's widespread use of thrombolytic therapy and primary coronary intervention, left ventricular (LV) pseudoaneurysms (PA) are now uncommon sequela of myocardial infarction. Nonetheless, when encountered, the decision of surgical versus medical therapy is not always clear. We present a patient who developed a massive postinfarct PA, likely due to ...
Crick Kathleen A - - 2007
Five patients, ages 63 to 79, had hemorrhagic complications involving the upper extremity from fibrinolytic therapy using intravenous tissue plasminogen activator (tPA) for acute myocardial infarction. The hemorrhages varied in severity. Three patients were treated for superficial hematomas, one with a deep subcutaneous hematoma producing skin necrosis, and one compartment ...
Kinsman Leigh - - 2007
BACKGROUND: International randomised controlled trials conducted over the last two decades have consistently demonstrated improved mortality and morbidity resulting from thrombolytic therapy for patients with acute myocardial infarction (AMI). Subsequently, evidence-based guidelines have been designed and implemented to optimize thrombolytic delivery. The effect of evidence-based clinical guidelines on clinical practice ...
Simpson Dene - - 2007
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus ...
Hegazy Aly Mohamad AM Non-Invasive Cardiac Laboratory, Farwania Hospital, Kuwait. - - 2007
To investigate the relationship between early T-wave inversion after thrombolytic therapy and the likelihood of successful epicardial coronary reperfusion. Thrombolytic therapy was given to 195 patients with ST segment elevation due to acute anterior myocardial infarction (AMI). Coronary angiography was performed. Receiver operating characteristic (ROC) curve (grade of sensitivity versus ...
Cheung N Wah - - 2006
In the last 10 years, there has been considerable interest in the administration of insulin as part of the management of myocardial infarction. This review examines the clinical trials of insulin infusion for myocardial infarction in the era of reperfusion therapy, and discusses the implications of the recently completed HI-5 ...
Ghadimi Hadi - - 2006
BACKGROUND: Few data exist about the clinical epidemiology of acute myocardial infarction and its complications and mortality in Iran. To fill this knowledge gap, we studied clinical characteristics and the outcome for a group of Iranian patients with acute myocardial infarction, who were, for the first time in our country, ...
Korotkov A - - 2006
The aim is to show the effectiveness of inhibitors of the kallikrein-kinin system (KKS) to avoid early microcirculation impairment and low reperfusion damages in the ischemic area during systemic thrombolysis (T) in order to achieve optimal results of thrombolytic therapy (TLT) in patients with acute myocardium infarction. Patients (n=104) with ...
Mendoza Cesar E - - 2007
Thrombolytic therapy remains the most commonly administered revascularization strategy for patients with ST-elevation myocardial infarctions (STEMI). However, many patients fail to have patent arteries or ST-segment resolution after these therapies. Multiple strategies have been examined to treat these patients with "failed thrombolysis." We examined the existing medical literature regarding treatment ...
Rizik David G - - 2006
Remarkable advances in our ability to achieve early and sustained culprit vessel patency in acute myocardial infarction have been satisfying, but our enthusiasm must be tempered by the knowledge that the overall treatment strategy often leaves an inadequate long term clinical result. Early success of percutaneous therapy as judged at ...
Chen Yu-Wei - - 2006
Diagnostic and interventional percutaneous coronary catheterization is associated with stroke. Many of such strokes are asymptomatic, but some are devastating. Once the diagnosis of acute cerebral infarction is confirmed, thrombolytic therapy should be administrated within the time window of 3 hours. We report a 61-year-old woman who suffered from an ...
Guidry, Ursula A.
The objective of this study were to assess the impact of a quality assurance effort on the door-to-needle time and the choice of thrombolytic agent for the management of acute myocardial infarction in the emergency department. The study design involved a prospective collection of data on a series of consecutive ...
Lin Han-Ching - - 2006
Acute renal infarction is a rarely reported disease in the medical literature. Angiography, renal scintigraphy, intravenous pyelography, sonography, and enhanced computed tomography may be useful in diagnosing acute renal infarction antemortem. Therapeutic guidelines for the treatment of renal infarction have not been established. We report a case of bilateral renal ...
El-Menyar Ayman A - - 2006
BACKGROUND: The presence of plasminogen activator inhibitor-1, angiotensin-converting enzyme and others may play a role in unsuccessful recanalization after thrombolytic therapy. OBJECTIVES: To find out the clinical and biochemical predictors that may affect the choice and short-term outcomes following different thrombolytic agents in acute myocardial infarction. METHODOLOGY: Angiotensin-converting enzyme and ...
Alter David A - - 2006
AIMS: To determine the relative impact of time to hospital arrival, baseline cardiovascular risk (i.e.TIMI mortality risk index), intracerebral haemorrhage risk, and comorbid disease burden on the likelihood of not receiving reperfusion therapy among ST-segment elevation myocardial infarction (STEMI) patients without contraindications to treatment. METHODS AND RESULTS: Retrospective population-based cohort ...
Leonhardt Georg - - 2006
Pregnancy due to its physiological changes is a procoagulant state. The rate of cardiac valve prosthesis thrombosis, deep venous thrombosis and pulmonary embolism are all increased. Thrombolytic therapy with tissue plasminogen activator (rt-PA) is an approved therapy for ischemic stroke, myocardial infarction, pulmonary embolism and thrombosis of cardiac valve prosthesis. ...
Gursoy Alptekin - - 2006
A 53-yr-old previously healthy man was admitted to our hospital for thyrotoxicosis without ophthalmopathy. Initial therapy with propylthiouracil caused an acute elevation of liver enzymes. Then, he received a first course of 131I therapy (20 mCi). At the end of 6-mo follow-up after 131I, he was still thyrotoxic and developed ...
El Menyar Ayman A - - 2006
The resistance to thrombolytic agents and delays in reperfusion occur in more than 30% after acute myocardial infarction. This may play an important role in the unsuccessful recanalization after thrombolytic therapy. The aim of this study is to assess the clinical and biochemical markers of reperfusion after different types of ...
Gonzales Nicole R - - 2006
Alteplase, an intravenously administered form of recombinant tissue plasminogen activator (rt-PA), remains the only US FDA-approved thrombolytic treatment for acute ischemic stroke within 3 h of symptom onset. Patients treated with intravenous rt-PA are at least 30% more likely to have minimal or no disability at 3 months compared with ...
Prasad Ravi S - - 2006
We describe the successful treatment of a 5-year-old girl with rapidly evolving left hemispheric hemorrhagic infarcts resulting from left transverse and sigmoid sinus thrombosis using combined endovascular dural sinus angioplasty and local low-dose thrombolytic therapy.
Simpson Dene - - 2006
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus ...
Sultan Sherif - - 2005
Subintimal angioplasty is a safe, effective, but nondurable procedure in treating long superficial femoral artery occlusions in patients with severe lower limb ischemia. The authors report a case of acute thrombosis that presented 16 weeks after subintimal angioplasty. The ;;Trellis'' percutaneous thrombolytic infusion system permitted a controlled site-specific infusion of ...
Hong Ting-Ting - - 2006
Plasmin-dependent thrombolytic agents are potentially prothrombotic and proinflammatory. Alfimeprase, a zinc-containing metalloproteinase, degrades fibrin directly and achieves thrombolysis independent of plasmin formation. This study examines the hypothesis that thrombolysis in the absence of plasmin generation results in improved myocardial salvage on reperfusion. The thrombolytic effects of recombinant tissue plasminogen activator ...
Puma Joseph A - - 2005
Acute peripheral arterial occlusion may be caused by thrombosis or embolism. The objectives of therapy are to preserve limb and life by restoration of blood flow. Thrombolytic therapy has been the mainstay, but is limited by a high risk of bleeding. Surgical treatment, often required, is invasive with higher rates ...
Quinn T - - 2005
BACKGROUND: Coronary care units were developed in the 1960s as specially equipped and staffed areas where patients with acute myocardial infarction could be monitored and offered rapid resuscitation from life-threatening arrhythmias. Awareness of the morbidity and mortality of the wider spectrum of acute coronary ischaemia was unrecognized at that time. ...
Krljanac Gordana - - 2005
The role of glucose-insulin-potassium (GIK) infusion in the management of acute myocardial infarction is not well established. This prospective, randomized study comprised 120 patients who had ST-elevation myocardial infarction that was treated within 12 hours from symptom onset with a high dose of GIK (25% glucose, 50 IU of soluble ...
Cruden Nicholas L M - - 2006
INTRODUCTION: Thrombolytic therapy fails to achieve reperfusion in almost a third of patients with acute myocardial infarction. Thrombin activatable fibrinolysis inhibitor (TAFI) and soluble CD40 ligand (sCD40L) are novel endogenous fibrinolytic and atherothrombotic factors that determine clot stability. We investigated whether admission plasma thrombin activatable fibrinolysis inhibitor (TAFI) and soluble ...
Galland R B - - 2005
OBJECTIVES: To examine size and distortion of popliteal aneurysms (PA) in relation to symptoms produced at presentation. METHODS: A prospective study of all PA presenting to a single unit 1988-1994. Wherever possible patients underwent angiography, duplex scanning and measurement of both PA diameter and the most proximal angle of distortion. ...
Hadi Hadi A R - - 2005
OBJECTIVE: Data on the outcome of patients treated with thrombolytic therapy in the Arab world is scarce. The main objective of this study is to study the 7-day morbidity and mortality rate and the rate of use of thrombolytic therapy in patients presenting with acute myocardial infarction treated with thrombolytic ...
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