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Mistry Nisha - - 2010
BACKGROUND: Thrombolysis remains the treatment of choice in acute ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be performed within 90 to 120 minutes. The optimal treatment after thrombolysis is still debated, but several studies have shown improved clinical outcomes with early transfer for PCI. The ...
Shelton Rhidian J - - 2010
BACKGROUND: It remains unclear whether the superiority of primary percutaneous coronary intervention (PPCI) over thrombolysis for the treatment of ST elevation myocardial infarction (STEMI) extends to the very elderly. Furthermore, the deliverability and efficacy of PPCI in over the 80s has not been investigated in a real-world setting. The aim ...
Hudson Michael - - 2010
We investigated whether transcutaneous ultrasound (TUS) augments coronary thrombolysis and achieves higher rates of Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and ST-segment resolution in patients with ST-segment elevation myocardial infarction (STEMI). In animal coronary and peripheral artery thrombosis models, low-frequency TUS enhances and accelerates thrombolysis. In a double-blind, ...
Weisenthal Benjamin M - - 2010
The Thrombolysis in Myocardial Infarction (TIMI) score, derived from unstable angina/non-ST-segment elevation acute myocardial infarction patient population, predicts 14-day cardiovascular events. It has been validated in emergency department (ED) patients with potential acute coronary syndrome with respect to 30-day outcomes. Our objective was to determine whether the initial TIMI score ...
Pereg David - - 2010
Mean platelets volume (MPV) has been shown to correlate with impaired reperfusion and increased mortality in patients with ST-elevation myocardial infarction (STEMI) treated with primary precutaneous coronary intervention (PCI). We aimed to study whether the same association exists in STEMI patients treated with thrombolysis. Included in the study were STEMI ...
Oe Kotaro - - 2010
A 73-year-old man was admitted to our hospital because of bilateral foot pain. He was treated with thrombolysis for cerebral infarction about 5 months ago. Anticoagulants had not been used because of hemorrhagic infarction. The pulses of bilateral pedal arteries were palpable, but cyanosis was present in the bilateral toes. ...
Fu Xiao-xia - - 2009
OBJECTIVE: To explore the cardiac protective effect of integrative therapy in acute myocardial infarction (AMI) with elevated ST segment after reperfusion. METHODS: Sixty-four AMI patients who having received decimalization by thrombolysis were assigned to two groups by retrospective analysis, 36 patients in the treated group and 28 in the control ...
Xuedong Shen - - 2010
Thrombolytic therapy is widely used to treat the patients with ST elevation acute myocardial infarction (STE-MI). Due to logistic and economic reasons, only 10% of patients with acute myocardial infarction can be treated with the percutaneous coronary intervention (PCI). Optimal flow (TIMI (Thrombolysis In Myocardial Infarction) 3 flow) is achieved ...
Huded Vikram - - 2009
Intra-arterial thrombolysis (IAT) is a treatment modality in patients with acute large vessel occlusive ischemic stroke. To our knowledge, this is probably the first reported study of intra-arterial thrombolysis in acute ischemic stroke from India. Of the 17 patients treated who recieved IAT, successful recanalization was achieved in nine patients, ...
Suri A - - 2009
A case is presented in which a 66-year-old man received thrombolysis for an acute ST elevation myocardial infarction (STEMI) within 6 minutes of developing chest pain. An ECG performed 10 minutes after thrombolysis showed complete resolution of the ST segment elevation and showed no other abnormality. An echocardiogram showed normal ...
Khan S N - - 2009
INTRODUCTION: Prehospital thrombolysis has been shown to improve patient outcomes in clinical trials and this has been confirmed in the ongoing large national myocardial infarction registry (Myocardial Infarction National Audit Project; MINAP) reports. This paper describes a system to improve the delivery of prehospital thrombolysis and the associated governance requirements ...
Bernardi Guglielmo - - 2009
Background: Percutaneous coronary intervention (PCI) is considered the best treatment for acute myocardial infarction with ST segment elevation (STEMI), but it is difficult to deliver. Objectives: To report on long-term mortality predictors in a registry based on a 'hub and spoke' model, according to the initial strategy: thrombolysis followed or ...
O'Connor Enda - - 2009
OBJECTIVE: To evaluate current evidence in support of therapies for preventing and treating cardiogenic shock (CS) after acute myocardial infarction that can be initiated in hospitals without invasive cardiac facilities. STUDY DESIGN: Systematic review. DATA SOURCES: MEDLINE and PubMed were searched from January 1985 to May 2008 using the MeSH ...
Köhrmann Martin - - 2009
BACKGROUND AND PURPOSE: Cerebellar infarctions constitute a significant proportion of ischemic strokes and carry a substantial morbidity and mortality mainly because of swelling in the posterior fossa. No specific acute therapy is established, and patients are usually excluded from intravenous thrombolysis (IVT). METHODS: Two patients presented in an extended time ...
Uyttenboogaart M - - 2009
In the last decennium, thrombolytic therapy has changed the management of acute ischemic stroke. Randomized clinical studies have demonstrated that intravenous thrombolysis with tissue plasminogen activator improves functional outcomes. Recently the time window for intravenous thrombolysis has been extended from 3 to 4.5 hours after stroke onset, which will allow ...
Vasilieva Elena - - 2009
BACKGROUND: Occlusion of the coronary artery is the main cause of ST-elevation myocardial infarction (STEMI). In some patients, it is followed by early spontaneous thrombolysis. In this study, we tried to determine whether spontaneous thrombolysis in the infarct-related artery (IRA) correlates with the state of the endothelium, which we assessed ...
Bongard V - - 2009
OBJECTIVE: To identify predictors of early TIMI 3 flow patency of the infarct-related artery after prehospital thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI) using data from a "real-world" population, and to develop a nomogram for triaging patients to emergency angiography. DESIGN: Multicentre, observational, prospective, cohort study. SETTING: 79 ...
Ross John J - - 2009
Prior important research is not always cited, exemplified by Oswald Avery's pioneering discovery that DNA is the genetic transforming factor; it was not cited by Watson and Crick 10 years later. My first laboratory research (National Institutes of Health 1950s) resulted in the clinical development of transseptal left heart catheterization. ...
Plate G - - 2009
OBJECTIVES: To find variables associated with outcome following thrombolytic treatment for acute lower limb ischemia. DESIGN: Re-analysis of a prospective multicentre study. MATERIAL AND METHODS: One hundred and twenty-one patients with acute lower limb ischemia previously included in a randomised study comparing high- with low-dose thrombolysis were re-analysed ignoring the ...
De Luca Giuseppe - - 2008
STUDY OBJECTIVE: Primary angioplasty is associated with benefits in survival as compared with thrombolysis among patients with ST-segment elevation myocardial infarction (STEMI). However, in daily practice only a minority of STEMI patients are admitted to 24-hour primary percutaneous coronary intervention hospitals. A previous meta-analysis failed to show significant benefits in ...
DeVries James T - - 2008
Early reperfusion therapy for acute stroke, similar to acute myocardial infarction, has the best opportunity to reduce morbidity and mortality. Treatment options include intravenous (IV) thrombolysis therapy and/or catheter-based therapy (CBT). Catheter-based therapies include local intra-arterial thrombolysis, mechanical thrombectomy, and angioplasty techniques. Intravenous thrombolysis is limited to the first three ...
Khatri Pooja - - 2008
During intra-arterial revascularization, either guide catheter injections of contrast in the neck or microcatheter contrast injections (MCIs) at or beyond the site of an occlusion, can be used to visualize intracranial vasculature. Neurointerventionalists vary widely in their use of MCIs for a given circumstance. We tested the hypothesis that MCIs ...
Cho A-Hyun - - 2008
BACKGROUND AND PURPOSE: We investigated whether focal hyperintensity on fluid-attenuated inversion recovery image within acute infarcts is associated with symptomatic intracerebral hemorrhage (SICH) after thrombolysis. METHODS: Patients with acute ischemic stroke who underwent MRI screening before thrombolysis were enrolled. The presence of focal fluid-attenuated inversion recovery hyperintensity within acute infarcts ...
Kobayashi Adam - - 2008
Intravenous thrombolysis is the only approved treatment for acute ischaemic stroke administered within 3 hours of onset. Mechanical embolectomy with the MERCI device is a new treatment option for patients with occlusion of a large cerebral artery who do not meet the current license criteria for thrombolysis, are admitted up ...
Sharma Vijay K - - 2008
BACKGROUND AND AIM: Intravenously-administered tissue plasminogen activator (IV-TPA) induces thrombolysis and remains the only FDA-approved therapy for acute ischaemic stroke. IV-TPA thrombolysis has been approved recently in Singapore for acute stroke. Continuous exposure of clot to 2-MHz pulsed-wave transcranial Doppler (TCD) ultrasound during IV-TPA infusion is known to augment thrombolysis. ...
Khatri Ismail A - - 2008
Acute ischaemic stroke is a major cause of neurological morbidity and mortality across the globe. Recent advances in past two decades have made complete reversal of life threatening stroke a reality. The judicious use of intravenous and intraarterial thrombolysis in acute ischaemic stroke has saved countless lives. The use of ...
Danchin Nicolas - - 2008
BACKGROUND: Intravenous thrombolysis remains a widely used treatment for ST-elevation myocardial infarction; however, it carries a higher risk of reinfarction than primary PCI (PPCI). There are few data comparing PPCI with thrombolysis followed by routine angiography and PCI. The purpose of the present study was to assess contemporary outcomes in ...
Jenkins Peter O - - 2008
The global burden of stroke, the undisputed success of intravenous thrombolysis in the management of myocardial infarction and subsequent evidence from animal models of cerebral infarction have all fuelled intense interest in the potential role for thrombolytic agents in the acute management of stroke in clinical practice. Before any clinical ...
Naito Yukari - - 2008
PURPOSE: We investigated the correlation between abnormal perfusion areas by computed tomography perfusion (CTP) study of hyperacute stroke patients and the final infarction areas after intraarterial catheter thrombolysis. MATERIALS AND METHODS: CTP study using the box-modulation transfer function (box-MTF) method based on the deconvolution analysis method was performed in 22 ...
Bertele' Vittorio - - 2008
The methodological and ethical value of equivalence and non-inferiority trials is questioned. These studies are still increasingly used in drug evaluation and accepted by the scientific community and the regulatory authorities. By applying the hypothesis of an equivalence trial of saruplase and streptokinase (SK) we proved that the no-thrombolysis approach ...
Brouwer Marc A - - 2008
BACKGROUND: Whether late coronary patency after myocardial infarction has prognostic impact independent of left ventricular function remains a matter of debate. Reocclusion rates in the first year after fibrinolysis vary between 20% and 30%. Of all reocclusions, about 30% present as clinical reinfarction, associated with a 2-fold-increased risk of mortality. ...
De Luca Giuseppe - - 2008
Several randomized trials and meta-analyses have shown that primary angioplasty is superior to thrombolysis in the treatment of ST-segment elevation myocardial infarction (MI) in terms of death, reinfarction, and stroke. However, primary angioplasty should be regarded as the preferred strategy as long as it can not be applied with a ...
Colombo Paola - - 2008
Each year, an estimated 10% of heart transplant recipients develop coronary allograft vasculopathy, an aggressive form of coronary artery disease that limits survival after transplantation. The pathologic characteristics of coronary allograft vasculopathy are not uniform and both the clinical importance and pathophysiological significance of thrombosis and vasospasm in this setting ...
Chong James J H - - 2008
Electrophysiologic studies predict the risk for sudden death after myocardial infarction (MI). Although primary angioplasty has become the preferred method of treatment for ST-elevation MI, intravenous thrombolysis remains the first-line treatment in 30% to 70% of cases worldwide. Rates of ventricular tachyarrhythmias may vary according to type of reperfusion treatment. ...
Han Moon-Ku - - 2008
BACKGROUND AND PURPOSE: Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) has demonstrated favorable clinical outcomes in a 3-6 h window in patients selected with perfusion/diffusion mismatch. However, the advantages of combined IV and intraarterial (IA) thrombolysis after 3 h of stroke onset are unexplored. METHODS: Acute ischemic stroke ...
Jones J B - - 2007
There is good evidence that timely restoration of coronary blood flow in obstructed infarct related arteries is a significant determinant of both short and long term mortality and morbidity. This is irrespective of whether it is achieved using fibrinolytic therapy or percutaneous coronary intervention (PCI). Despite the clear advantages of ...
Brueck Martin - - 2007
Randomized clinical trials have clearly shown that early reperfusion of coronary arteries is the established treatment of myocardial infarction preserving left ventricular function and reducing mortality. However, late patency of the infarct-related artery is an independent predictor of survival leading to the late open-artery hypothesis. This concept implies restoration of ...
Tountopoulou Argyro - - 2008
INTRODUCTION: The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute stroke due to occlusion in the anterior or posterior circulation. METHODS: We retrospectively analyzed the clinical and radiological data of 88 consecutive patients ...
Arntz Hans-Richard - - 2008
Up to 90% of cardiac arrests are due to acute myocardial infarction or severe myocardial ischaemia. Thrombolysis is an effective treatment for ST-elevation myocardial infarction (STEMI), but there is no evidence or guideline to put forward a thrombolysis strategy during cardiopulmonary resuscitation (CPR). In two physician-manned emergency medical service (EMS) ...
Lee Kiwon - - 2007
The National Institute of Neurological Disorders and Stroke trial of recombinant tissue plasminogen activator has been considered a landmark study in the acute treatment of ischemic stroke. Unfortunately, only a small percentage of all ischemic stroke patients presents to the hospital in time to receive the drug. Moreover, the recannalization ...
Kucher Nils - - 2007
Massive pulmonary embolism (PE) is a life-threatening condition with a high early mortality rate due to acute right ventricular failure and cardiogenic shock. As soon as the diagnosis is suspected, an IV bolus of unfractionated heparin should be administered. In addition to anticoagulation, rapid initiation of systemic thrombolysis is potentially ...
Iijima Raisuke - - 2007
BACKGROUND: Recent studies have shown that a global flow abnormality affects the entire coronary tree in patients with acute coronary syndrome (ACS), and that it is associated with adverse outcomes. Postprandial hyperglycemia is also thought to promote coronary endothelial dysfunction, as well as the release of inflammatory and vasoconstrictive factors. ...
De Luca Giuseppe - - 2007
Several randomized trials and meta-analyses have shown that primary angioplasty is superior to thrombolysis in the treatment of ST-segment elevation myocardial infarction (STEMI) in terms of death, re-infarction and stroke. However, primary angioplasty should be regarded as the preferred strategy unless it could not be applied with a reasonable time-delay ...
Steinberg Benjamin A - - 2007
BACKGROUND: Outcomes in patients with ST-elevation myocardial infarction (STEMI) differ between those in clinical trials and those in routine practice, as well as across different regions. We hypothesized that adjustment for baseline risk would minimize such variations. METHODS: The Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thrombolysis In Myocardial ...
Barbagelata Alejandro - - 2007
BACKGROUND AND OBJECTIVES: Mortality from ST-segment elevation myocardial infarction remains high, with most deaths occurring before hospital admission. Despite effective pre- and in-hospital reperfusion strategies becoming standard over the past 2 decades, time-to-admission and time-to-treatment remain prolonged. We reviewed temporal trends in these times in published clinical trials. METHODS: All ...
Foading Deffo Bertin - - 2007
Acute myocardial infarction is rare in women of childbearing age, especially in the absence of common risk factors. We describe the case of a 38-year-old multiparous woman with anterior myocardial infarction treated with thrombolysis, followed by percutaneous coronary angioplasty. The patient developed transient heart failure within the first week. The ...
Chen Zhong - - 2007
A 39-year-old Zimbabwean man presented with a 1 week history of fever, general malaise and acute-onset chest pain. He had a urethral stricture, which had been managed with an indwelling supra-pubic catheter. The electrocardiography on admission showed inferior ST-T segments elevation. His chest pain and electrocardiography changes resolved subsequent to ...
Agarwal R - - 2007
Pulmonary embolism (PE) is a common and a potentially life-threatening disease. Diagnosis is challenging because the signs and symptoms are non-specific. Moreover treatment of PE is shrouded in controversy. Even at presentation the role of thrombolysis in managing patients with PE remains unclear. In those patients with right heart thromboemboli, ...
Christoforidis Gregory A - - 2007
BACKGROUND AND PURPOSE: This study defines significant thrombolysis associated intracranial hemorrhage (ICH) by identifying an objective threshold volume that predicts clinical deterioration attributable to ICH. METHODS: Prospectively collected clinical and radiographic information, from 103 consecutive patients who underwent intraarterial thrombolysis for acute ischemic stroke, was reviewed. Multiple paired comparisons between ...
Kent David M - - 2007
Primary percutaneous coronary intervention (PPCI) yields superior mortality outcomes compared with thrombolysis in ST-elevation acute myocardial infarction (STEMI) but takes longer to administer. Previous meta-regressions have estimated that a procedure-related delay of 60 minutes would nullify the benefits of PPCI on mortality. Using a combined database from randomized clinical trials ...
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