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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 ...
Foussas S G - - 2007
OBJECTIVES: To evaluate, using continuous 12-lead ECG ST-segment monitoring, the role of circulating levels of both cardiac troponin I (cTnI) and high-sensitivity C reactive protein (hs-CRP), on presentation, in the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction (STEMI). DESIGN AND SETTING: Prospective observational study in ...
Asseburg Christian - - 2007
Meta-analyses of trials have shown greater benefits from angioplasty than thrombolysis after an acute myocardial infarction, but the time delay in initiating angioplasty needs to be considered. To extend earlier meta-analyses by considering 1- and 6-month outcome data for both forms of reperfusion. To use Bayesian statistical methods to quantify ...
Sen Nihat - - 2007
BACKGROUND: Epicardial coronary arteries are normal in patients with cardiac syndrome X. It is, however, unclear whether there is an abnormality at the level of microvascular circulation. In this study, our aim was to evaluate the epicardial coronary blood flow and myocardial perfusion in patients with cardiac syndrome X. METHODS: ...
Zangerle A - - 2007
OBJECTIVE: To estimate rates, predictors, and prognostic importance of recanalization in an unselected series of patients with stroke treated with IV thrombolysis. METHODS: We performed a CT angiography or transcranial Doppler (TCD) follow-up examination 24 hours after IV thrombolysis in 64 patients with documented occlusion of the intracranial internal carotid ...
Bøhmer Ellen - - 2007
OBJECTIVES: Thrombolysis is the treatment of choice for patients with ST-elevation myocardial infarction (STEMI) living in rural areas with long transfer delays to percutaneous coronary intervention (PCI). This trial compares two different strategies following thrombolysis: to transfer all patients for immediate coronary angiography and intervention, or to manage the patients ...
Widimsky Petr - - 2007
Extremely long-term follow-up (24 years) of the historically first Czech myocardial infarction patient, treated by intracoronary thrombolysis, is presented. His current coronary angiography confirmed the finding 24 years ago, that this was a case of smoking-induced thrombosis in otherwise healthy coronary arteries. Experience with 76 similar cases among 4093 consecutive ...
Molina Carlos A - - 2007
In the last few years, several studies have improved our knowledge and understanding of the dynamic nature of the recanalization process during stroke thrombolysis. Transcranial Doppler ultrasound provides a unique opportunity to assess several aspects of clot dissolution by means of continuous monitoring of recanalization during and after administration of ...
Kendall J - - 2007
There is currently much debate about the relative roles of pharmacological reperfusion (ie, thrombolysis) and mechanical reperfusion (ie, primary percutaneous coronary intervention (PPCI) in the management of patients with acute ST segment elevation acute myocardial infarction (STEMI). Whilst the scientific debate is reaching some resolution in terms of appropriate interpretation ...
Tello-Montoliu Antonio - - 2007
BACKGROUND: Common carotid intima-media thickness (CIMT) has been related to cardiovascular risk factors, coronary atherosclerosis and a higher risk of myocardial infarction. Evaluation of intracranial arteries by transcranial Doppler explores the presence of vascular dysfunction at this level. We tested the hypothesis that CIMT and Doppler Pulsatility Index (DPI) can ...
Mukamal Kenneth J - - 2006
BACKGROUND: Controversy remains about whether early to bed and early to rise makes a man healthy, wealthy and wise (the Ben Franklin hypothesis), or healthy, wealthy and dead (the James Thurber hypothesis). METHODS: As part of the Determinants of Myocardial Infarction Onset Study, we determined through personal interviews the bedtimes ...
Shin Dong Il - - 2006
BACKGROUND: The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: A total of 31 patients with STEMI underwent MDCT scanning within 6 h (mean 4.6+/-1.1) ...
Koroneos Apostolos - - 2007
We report the life-saving administration of thrombolysis during cardiopulmonary resuscitation in a patient with recent intracerebral haemorrhage. A 53-year-old male with intracerebral haemorrhage was admitted to the intensive care unit. On the 24th day of treatment he suffered cardiac arrest with pulseless electrical activity. Transoesophageal echocardiography was performed during ongoing ...
Lee Chi Hang - - 2006
OBJECTIVE: In the thrombolytic era, it was reported that in the presence of significant coronary stenosis, lowering diastolic blood pressure (DBP) below a critical threshold would result in a paradoxical increase in the occurrence of myocardial infarction (MI). We sought to re-evaluate this J-shaped relation in the era of pharmacoinvasive ...
Amit Guy - - 2006
BACKGROUND: The aim of this study was to test whether nitroprusside (NTP) injected intracoronary immediately before primary angioplasty for acute ST-elevation acute myocardial infarction (STEMI) prevents no-reflow and improves vessel flow and myocardial perfusion. METHODS: Ninety-eight patients presenting with STEMI were evenly randomized to receive either NTP (60 microg) or ...
Chongtham Dhanaraj Singh - - 2006
The aim of this study was to assess the feasibility, safety and efficacy of telecardiology-guided initiation of therapy and management of acute coronary syndrome at primary care hospitals before the transfer of the patient to a tertiary care center. This study covered 25 of 41 patients diagnosed with acute coronary ...
Belle L - - 2006
The effectiveness of thrombolytics has been clearly demonstrated in more than half the cases in the large cohorts of patients selected for trials during the acute phase of myocardial infarction. At individual level, thrombolysis will clinically either succeed or fail so, for the medical team managing the patient, choice of ...
Steg P G - - 2006
OBJECTIVE: To study the impact on outcomes of direct admission versus emergency room (ER) admission in patients with ST-segment elevation myocardial infarction (STEMI) DESIGN: Nationwide observational registry of STEMI patients SETTING: 369 intensive care units in France. INTERVENTIONS: Patients were categorised on the basis of the initial management pathway (direct ...
Rubiera Marta - - 2006
BACKGROUND AND PURPOSE: Although tandem internal carotid artery/middle cerebral artery (MCA; TIM) occlusion has been associated with low recanalization rate after IV tissue plasminogen activator (tPA), its independent contribution on stroke outcome remains unknown. Moreover, whether the relative resistance to thrombolysis in tandem lesions varies depending on the location of ...
Hanson T C - - 2006
BACKGROUND AND OBJECTIVES: After an acute myocardial infarction (AMI) prehospital thrombolysis (PHT) reduces mortality compared with inhospital thrombolysis. In practice, a relatively small proportion of the total population with AMI receives PHT. This study was designed to identify the current barriers to PHT. METHODS: A retrospective practice review of 57 ...
Samimi-Fard Sima - - 2006
At present, thrombolysis remains the principal reperfusion strategy for ST-elevation acute coronary syndromes in most countries, due to the limited availability of primary angioplasty. Haemorrhagic complications, which are among the most frequent side effects, are usually not very important. As a matter of fact, 70% of the bleeding takes place ...
Kovacs Iren B - - 2006
Substantial evidence suggests that spontaneous thrombolytic activity of blood is an effective mechanism for protection against tissue damage that is the consequence of lasting arterial occlusion. Despite the generally held belief that coronary artery disease and stroke are preventable, a promising avenue of prevention, namely the identification and prophylactic treatment ...
Ozkan U─čur - - 2006
Acute portal vein thrombosis (PVT) is a rare clinical condition that can cause portal hypertension and bowel infarction. Early diagnosis and treatment of PVT is crucial for the restoration of portal venous flow and reduction of morbidity and mortality. We report a successful treatment of acute PVT which was seen ...
Khatri Pooja - - 2006
Stroke is an important complication after cardiac catheterization procedures, resulting in death and disability for thousands of patients each year. Common risk factors include advanced age, vascular comorbidities, and more complicated and invasive procedures. Several lines of evidence suggest that these strokes are embolic, from either dislodgement of a clot ...
Kovacs I B - - 2006
Spontaneous thrombolysis is an endogenous protective mechanism against lasting arterial thrombotic occlusion, which is implicated in the pathogenesis of myocardial infarction and acute coronary events. Novel therapies for coronary heart disease (CHD) targeting atherosclerosis and thrombosis, together with cardiovascular prevention programs targeting risk-factors and lifestyle provide evidence that CHD is ...
Musuraca Gerardo - - 2006
The electrocardiogram, when applied in the prehospital setting, has a significant effect on a patient with chest pain. The potential effect includes both diagnostic and therapeutic issues, including the diagnosis of acute myocardial infarction and the indication for thrombolysis or invasive procedures. We report the case of a man who ...
Björklund Erik - - 2006
AIMS: There are sparse data on the impact of pre-hospital thrombolysis (PHT) in real-life patients. We therefore evaluated treatment delays and outcome in a large cohort of ambulance-transported real-life patients with ST-elevation myocardial infarction (STEMI) according to PHT delivered by paramedics or in-hospital thrombolysis. METHODS AND RESULTS: Prospective cohort study ...
Banyo Fujii / Kiyoshi ...
We present 4 cases of acute reocclusion of a coronary artery . They had total occlusion at the time of acute myocardial infarction, and had beenrecanalized with intracoronary urokinase infusion with a residual lesion of less than 50%. Reocclusion occurred by thrombus formation at the same location, where total occlusion ...
Barsam Allon - - 2006
Suprachoroidal haemorrhage occurs most commonly as an intraoperative or a postoperative complication of ocular surgery. Spontaneous suprachoroidal haemorrhage is rare. Herein a case is described of spontaneous suprachoroidal haemorrhage in a patient who received recombinant tissue plasminogen activator for the treatment of a myocardial infarction. Systemic thrombolysis may induce spontaneous ...
Dragu Robert - - 2006
Data from patients who had ST-elevation acute myocardial infarction and renal failure and were enrolled in the 2002 Acute Coronary Syndrome Israeli Survey (ACSIS) were studied to determine the effect of different myocardial reperfusion modalities on short- and long-term outcomes. Thirty-day crude mortalities were 8.3% in the thrombolysis group, 40.0% ...
Daffertshofer Michael - - 2006
Reopening of the occluded artery is the primary therapeutic goal in hyperacute ischemic stroke. Systemic treatment with tissue recombinant plasminogen activator (tPA) has been shown to be beneficial at least in a 3-hour door to needle window. Intra-arterial thrombolysis is favorable and opens the window of treatment up to at ...
Galiuto Leonarda - - 2006
Previously defined as the failure to achieve uniform intramyocardial reperfusion after prolonged but reversible coronary occlusion, only recently has no-reflow phenomenon been characterized as a heterogeneous clinical condition. In fact, in about half of post-infarct patients that show no-reflow after 24 hours from coronary recanalization by either thrombolysis or PTCA, ...
Chase D - - 2006
To quantify the health gains and costs associated with improving ambulance and thrombolysis response times for acute myocardial infarction. A computer simulation model. PATIENTS/SETTINGS: Patients experiencing acute myocardial infarction in England. Improving the ambulance response time to 75% of calls reached within 8 minutes and the hospital arrival to thrombolysis ...
Khatri Pooja - - 2005
BACKGROUND AND PURPOSE: The acute stroke literature lacks a standard convention regarding the critical end point of revascularization. Two distinct parameters may be clinically important: (1) recanalization of the primary arterial occlusive lesion (AOL) and (2) global reperfusion of the distal vascular bed. We sought to determine their relationship in ...
De Luca Giuseppe - - 2005
BACKGROUND: Although the benefits of primary angioplasty for ST-segment elevation myocardial infarction (STEMI) have been demonstrated, the prognostic role of early recanalization in these patients has yet to be investigated. The aim of the study was to evaluate the impact of preprocedural Thrombolysis in Myocardial Infarction (TIMI) flow on the ...
Iqbal M Perwaiz - - 2005
OBJECTIVE: N-acetyl-beta-D-glucosaminidase (NAG) is a lysosomal enzyme of which the activity in plasma is increased in a number of conditions including myocardial infarction. Plasma levels of cardiac proteins, such as myoglobin, troponin and creatine kinase, have been used as markers of myocardial reperfusion as well as for the prognosis of ...
Buber Jonathan - - 2005
BACKGROUND: ST segment resolution (STR) is a strong predictor of outcome following thrombolysis. If failure of STR could be predicted on admission, better selection of treatment may be possible. Among patients given reperfusion, those with terminal QRS distortion (grade 3 ischemia) have larger infarcts, but the mechanism underlying this association ...
Bigi Riccardo - - 2005
The association between admission electrocardiogram and 6-month change in left ventricular function and volume was assessed in 200 patients who had acute myocardial infarction that was treated with primary percutaneous coronary intervention. Logistic regression analysis indicated peak creatine phosphokinase-MB, number of Q-wave leads, QRS interval distortion, wall motion score index, ...
Lengyel Maria - - 2005
Prosthetic valve thrombosis (PVT) is a life-threatening disease, for which treatment strategies have been controversial. Herein, existing data on management options are reviewed, and conclusions drawn as to the choice and use of treatment strategies for PVT. The use of transesophageal echocardiography (TEE) allows distinction to be made between obstructive ...
Reuben A D - - 2005
OBJECTIVES: To redesign and simplify an existing decision algorithm for the management of patients who present to the emergency department with chest pain and left bundle branch block (LBBB) based on the Sgarbossa criteria. To compare its reliability with the current algorithm. METHODS: A simplified algorithm was created and tested ...
Toumpoulis Ioannis K - - 2005
BACKGROUND: Coronary artery bypass grafting (CABG) is frequently used after thrombolytic therapy. However, there is little information regarding long-term survival in this setting. The purpose of the present study was to compare the long-term survival of patients subjected to CABG after thrombolysis to those without thrombolysis. METHODS AND RESULTS: We ...
Tziakas Dimitrios N - - 2006
INTRODUCTION: Matrix metalloproteinases (MMPs) are expressed in atherosclerotic plaques. Acute coronary syndromes may be precipitated by MMPs through degradation of the fibrous cap and subsequent plaque disruption. Serine proteases such as plasmin activate MMPs and may contribute to plaque events. Thrombolysis with recombinant tissue plasminogen activator (rtPA) is widely used ...
Ovbiagele Bruce - - 2005
Smokers with acute myocardial infarction have better outcomes after thrombolysis than nonsmokers. The authors evaluated the independent effect of smoking on short-term outcome following IV thrombolysis for acute ischemic stroke. After adjusting for covariates, recent smokers who received thrombolysis had a significantly greater drop in 24-hour median stroke severity scores ...
Banerjee P - - 2005
BACKGROUND: Thrombolysis is still the first line of treatment for acute myocardial infarction in the United Kingdom. In a significant proportion of these patients thrombolytic therapy fails to restore patency of the occluded artery or is followed by early re-infarction. The best management of this group of patients is not ...
Bedetti Gigliola - - 2005
BACKGROUND: High-dose glucose-insulin-potassium (GIK) solution has beneficial effects on reducing mortality in acute myocardial infarction. Dipyridamole (DIP) is a powerful antioxidant and increases adenosine concentration. Experimentally, GIK and DIP have additive protective effects in ischemia-reperfusion injury. AIM: This work aims to assess the acute effects of DIP alone, GIK alone, ...
Pfaffenberger Stefan - - 2005
Cardiovascular diseases are a major cause of mortality in the developed world. Efficacy of thrombolysis plays an important role in the management of acute myocardial infarction and cerebral insult both in the acute event and in the long-term outcome of these patients. New adjunctive strategies have been tested, therefore, to ...
Chockalingam Anand - - 2005
Acute inferior wall myocardial infarction can be complicated by right ventricular myocardial infarction (RVMI), and the excess mortality cannot be fully explained by mechanical reasons. The authors try to systematically assess the incidence, clinical presentation and early outcomes of right ventricular infarction in a tertiary-care setup. Their study was a ...
Zavala-Alarcon Edgardo - - 2005
Slow flow of dye in epicardial coronary arteries is not an infrequent finding in patients during routine coronary angiography. The extreme form of this phenomenon, namely, no flow or Thrombolysis in Myocardial Infarction (TIMI) 0-1, is very uncommon with life-threatening consequences. We consider the present report as the first one, ...
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