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Results 201 - 250 of 717
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Herlitz Johan - - 2003
BACKGROUND: During the last decade, there has been an on-going debate with regard to whether percutaneous coronary intervention (PCI) or thrombolysis should be preferred in patients with ST-elevation acute myocardial infarction (AMI). Some studies clearly advocate PCI, while others do not. HYPOTHESIS: The study aimed to describe the characteristics and ...
Kurkciyan I - - 2003
OBJECTIVE: The risk of bleeding complications caused by thrombolysis in patients with cardiac arrest and prolonged cardiopulmonary resuscitation is unclear. We evaluate the complication rate of systemic thrombolysis in patients with out-of-hospital cardiac arrest caused by acute myocardial infarction, especially in relation to duration of cardiopulmonary resuscitation. DESIGN: The study ...
Bond Matthew - - 2003
OBJECTIVES: To analyse access by age to exercise testing, coronary angiography, revascularisation (percutaneous transluminal coronary angioplasty/stent insertion and coronary artery bypass graft surgery) and receipt of thrombolysis, where indicated, for hospital patients with diagnosed cardiovascular disease. METHOD: Retrospective case note analysis, tracking each case backwards and forwards by 12 months ...
Spöhr Fabian - - 2003
The prognosis is generally poor for patients who experience a cardiac arrest. The most common causes of sudden cardiac arrest are massive pulmonary embolism (PE) and acute myocardial infarction (MI). While thrombolysis is a first-line treatment option in massive PE and acute MI, cardiopulmonary resuscitation (CPR) has been regarded as ...
Gilbert J A - - 2003
A convenience sample of 50 patients admitted for treatment or ruling out of acute myocardial infarction were asked about their knowledge of thrombolysis. Some 44 of 50 knew nothing of thrombolysis and interestingly 30 of these 44 had been previously diagnosed as having ischaemic heart disease. Greater knowledge of the ...
Sabatine Marc S - - 2002
OBJECTIVES: This study was designed to determine the relationship between baseline white blood cell (WBC) count and angiographic and clinical outcomes in patients with unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) and to see if WBC count was a significant predictor of outcomes independent of other biomarkers. BACKGROUND: Inflammation has ...
Alexandrov Andrei V - - 2002
In the pivotal clinical trials of intravenous tissue plasminogen activator (TPA) therapy for ischemic stroke, a low rate of early arterial recanalization was suspected due to the small numbers of patients who had early dramatic clinical improvement. TPA activity can be enhanced with ultrasound including 2 MHz transcranial Doppler (TCD). ...
Burzotta F - - 2002
Four cases of young patients with acute myocardial infarction are discussed in which urgent angiography showed large intracoronary thrombus and TIMI (thrombolysis in myocardial infarction) flow > or = 2 in the infarct related artery. The rest of the coronary tree appeared to be free of detectable atherosclerosis. Percutaneous transluminal ...
Pate G E - - 2002
Saint James' Hospital is a 650-bed tertiary referral hospital. An audit was performed of acute transmural myocardial infarctions for the years 1996 to 1999 inclusive. On average there were 2043 cardiology admissions annually, 9.8% of all hospital admissions. Acute transmural myocardial infarction was diagnosed in 178 patients annually, and was ...
Ronner E - - 2002
In order to study the safety of 'rescue' strategies in the treatment of patients with failed thrombolysis, all 548 patients admitted with evolving myocardial infarction to the Thoraxcenter, Rotterdam, from January 1997 until April 1999 were reviewed. Of these patients, 49% had received thrombolysis. Of patients treated with thrombolysis and ...
Gamon R - - 2002
The publication of the National Service Framework for Coronary Heart Disease has meant that audit is becoming an increasingly important part of cardiac healthcare provision in England. Comparisons between hospitals will be made so it is essential that the audit data is as robust as possible. Nurses often play a ...
Stephenson D T - - 2002
This paper forms the second part of the debate on prehospital thrombolysis (PHT). It is argued that large scale studies have failed to show a benefit for PHT, even when the time saved over conventional treatment was considerably greater than would be the case in the UK urban setting. In ...
Wagner Andreas - - 2002
In a placebo-controlled, double-blinded, randomized study we evaluated the effect of ramipril prior to thrombolysis on the course of PAI-1 plasma levels and on the frequency of postinfarct ischemic events in patients with acute myocardial infarction. Fifty-one out of 99 patients received 2.5 mg ramipril orally prior to thrombolysis and ...
Morrow David A - - 2002
OBJECTIVES: The Early Retavase-Thrombolysis In Myocardial Infarction (ER-TIMI) 19 trial tested the feasibility of prehospital initiation of the bolus fibrinolytic reteplase (rPA) and determined the time saved by prehospital rPA in the setting of contemporary emergency cardiac care. BACKGROUND: Newer bolus fibrinolytics have undergone only limited evaluation for prehospital administration. ...
Angeja Brad G - - 2002
BACKGROUND: Despite increased risk for coronary artery disease and acute myocardial infarction (AMI), smokers have a paradoxically lower mortality after thrombolysis for AMI than non-smokers. We determined the clinical risk profiles and coronary flow characteristics of patients in the TIMI trials according to smoking status, focusing on microvascular flow. METHODS: ...
Qureshi Adnan I - - 2002
OBJECTIVE: The Thrombolysis in Myocardial Infarction (TIMI) grading scheme and other classification systems are limited because they do not account for occlusion location or collateral circulation. A new scheme for angiographic classification of arterial occlusion and recanalization response to intra-arterial thrombolysis in acute ischemic stroke was designed because of limitations ...
Molina Carlos A - - 2002
BACKGROUND AND PURPOSE: The role of early and delayed recanalization after thrombolysis in the development of hemorrhagic transformation (HT) subtypes remains uncertain. We sought to explore the association between the timing of recanalization and HT risk in patients with proximal middle cerebral artery (MCA) occlusion treated with intravenous recombinant tissue ...
Nagao Ken - - 2002
The efficacy and safety of fibrinolysis and subsequent transluminal (FAST) therapy were evaluated in 195 patients with acute myocardial infarction (AMI) for the early achievement of thrombolysis-in-myocardial-infarction grade 3 (TIMI-3) flow in the infarct-related artery. Intravenous thrombolysis using the optimal dose of a thrombolytic agent was initiated immediately after arrival ...
Qasim Asif - - 2002
Delay in starting thrombolytic treatment in patients arriving at hospital with chest pain who are diagnosed as having acute myocardial infarction. Audit of "door to needle times" for patients presenting with chest pain and an electrocardiogram on admission that confirmed acute myocardial infarction. A one year period in each of ...
Joy M A - - 2002
Strokes following cardiac surgery occur in about 5% of patients. Intra-arterial thrombolysis is a good option in such a setting where intravenous thrombolysis is contraindicated, and when in-hospital strokes are detected well within the window for treatment and the chances of complete reperfusion are maximum. On postoperative day 4 after ...
Kuether Todd A - - 2002
Chemical thrombolysis has been the mainstay of acute stroke treatment; however, these methods come with the risk of potentially lethal intracerebral hemorrhage. This article discusses the different methods of mechanical thrombolysis and other techniques used in the treatment of acute stroke, including angioplasty and stent placement. Some of the very ...
Zijlstra F - - 2002
AIMS: We examined the clinical characteristics and outcome of patients with early (<2 h), intermediate (2-4 h) and late (>4 h) presentation treated by primary angioplasty or thrombolytic therapy for acute myocardial infarction. METHODS AND RESULTS: We studied 2635 patients enrolled in 10 randomized trials of primary angioplasty (n=1302) vs ...
Luciardi Héctor - - 2002
Intracoronary thrombus formation results from the combined effects of platelet aggregation and fibrin formation. Fibrinogen plays a significant role in each of these components. Dethrombosis is a therapeutic approach that allows dissolution of a recent thrombus while avoiding the potent fibrinolytic therapies. The less aggressive strategies suggested to achieve dethrombosis ...
Snyder-Ramos S A - - 2002
Recently, efforts have been undertaken to investigate the effects of thrombolysis during cardiopulmonary resuscitation (CRP) in patients suffering from massive pulmonary embolism or acute myocardial infarction. In up to 70% of patients with cardiac arrest, one of these two diseases is the underlying cause of deterioration. Nevertheless, thrombolysis has not ...
Varnava A M - - 2002
BACKGROUND: Early discharge after myocardial infarction is safe and feasible. Factors that delay discharge need to be identified in order to improve care and reduce bed occupancy. OBJECTIVE: To investigate the potential of the restricted weekend service that operates in most hospitals to delay patient discharge. DESIGN: Prospective cohort study. ...
Smits Henk F M - - 2002
BACKGROUND: Percutaneous thrombolysis has become an accepted treatment of thrombosed haemodialysis grafts. Several devices have been developed for mechanical thrombolysis, which macerate the clot using different mechanisms such as aspiration and fragmentation. The aim of our study was to compare the efficacy of three devices for mechanical thrombolysis in removing ...
Moreno Raúl - - 2002
OBJECTIVES: This study aimed to evaluate the effect of primary angioplasty (PA) over the risk of free wall rupture (FWR) in reperfused acute myocardial infarction (AMI). BACKGROUND: It has been suggested that PA reduces the risk of FWR compared with thrombolysis. However, few studies have evaluated this issue, and there ...
Hancock J E - - 2002
BACKGROUND: The aim of the present study was to determine the use of cyclic variation in ultrasonic integrated backscatter (IBS), which is reduced in ischemic myocardium, to predict an occluded infarct-related artery (IRA) after thrombolysis for acute myocardial infarction (AMI). This is important, because patency of the IRA 90 minutes ...
Cundiff David K - - 2002
The proof of efficacy of thrombolysis for acute myocardial infarction (AMI) depends on 9 randomized placebo-controlled trials totaling 58,511 patients. The meta-analysis of these trials showed an overall survival advantage of about 2% (11.5% vs 9.6%) in favor of thrombolysis. Iatrogenic deaths from thrombolysis complications occur in about 1% of ...
Birnbaum Yochai - - 2002
We assessed the relation between baseline electrocardiographic ischemia grades and initial myocardial area at risk (AR) and final infarct size (IS) in 49 patients who had undergone (99m)Tc sestamibi single-photon emission computed tomography before and 6 +/- 1 days after thrombolysis. Patients were classed as having grade III ischemia (ST ...
Jachmann-Jahn U - - 2001
A 42-year-old man was admitted with heavy retrosternal pain lasting 30 min. Electrocardiography showed typical signs of acute anterior myocardial infarction. The patient reported only attacks of coughing for a couple of days, and no serious diseases. The physical examination was normal. Laboratory tests showed a white blood cell count ...
Toni D - - 2001
Ischaemic penumbra is defined as the area of brain tissue that maintains some blood flow following ischaemic accident. This zone may be rescued by both neuroprotection and arterial revascularization. Early thrombolysis has been used with encouraging results since 1995 in several trials testing both streptokinase and recombinant tissue plasminogen activator ...
Rabasseda Xavier - - 2001
Tenecteplase, a new fibrinolytic with longer plasma half-life and greater specificity for fibrin than alteplase, achieves rapid thrombolysis in patients with acute myocardial infarction. Similar TIMI grade 3 flow rates at 90 minutes have been observed with tenecteplase and alteplase. The efficacy and safety of tenecteplase have been confirmed in ...
Birnbaum Y - - 2001
We investigated the impact of primary angioplasty compared with thrombolysis in 894 patients with ST elevation acute myocardial infarction and electrocardiographic grades II and III ischemia on enrollment. Patients were divided into 2 groups based on the enrollment electrocardiogram-grade III: (1) absence of an S wave below the isoelectric baseline ...
Arntz H R - - 2001
Efficacy of reperfusion therapy in acute myocardial infarction (AMI) is strictly time-dependent. Most benefit is achieved with initiation of therapy within the first 60-90 min after onset of symptoms. The majority of patients with AMIs are seen within this time window by emergency medical services. Moreover, average time gain of ...
Chandwaney R H - - 2001
Kawasaki's disease is an acute systemic vasculitic syndrome that primarily affects children. Coronary aneurysms are common vasculitic sequelae of Kawasaki's disease. Intracoronary thrombosis and embolization are potential consequences of coronary aneurysms. We describe our experience of successful thrombolysis using the combination of reduced-dose intravenous tissue plasminogen activator and abciximab as ...
Cheneau E - - 2001
OBJECTIVE: This prospective study sought to determine the rate of thrombolysis in myocardial infarction and the factors that influenced it in everyday practice. METHODS AND RESULTS: Data were prospectively collected in all patients admitted in all (48) university, community, and private hospitals in three departments in the Rhĵne-Alpes region in ...
Zahn R - - 2001
BACKGROUND: In patients with acute myocardial infarction treated with thrombolysis, longer times to treatment are associated with increasingly worse clinical outcome. This relation may be different for treatment with primary angioplasty. METHODS: We analyzed the pooled data of the German acute myocardial infarction registries Maximal Individual Therapy in Acute Myocardial ...
Loubeyre C - - 2001
BACKGROUND: Primary therapies in acute myocardial infarction (thrombolysis and angioplasty) have inherent limitations which may be overcome by combining them. So far, no trial has demonstrated a clinical benefit in combining mechanical and pharmacological treatment strategies. METHODS: From January 1995 to December 1999, out of 1010 patients admitted to our ...
Mentzelopoulos S D - - 2001
This report shows that if diffuse coronary thromboembolism is encountered during ascending aortic dissection-repair, the option of combining single-bolus, intracoronary thrombolysis with intraaortic balloon counterpulsation should be considered.
Ringer A J - - 2001
OBJECTIVE: Thrombolysis has been demonstrated to improve revascularization and outcome in patients with acute ischemic stroke. Many centers now apply thrombolytic therapy locally via intra-arterial infusion. One therapeutic benefit is the ability to cross soft clots with a guidewire and to perform mechanical thrombolysis. In some instances, reopened arteries reocclude ...
Rosengarten P - - 2001
OBJECTIVE: It has been suggested that the use of additional electrocardiogram leads might improve the diagnostic sensitivity of this test, thus potentially expanding eligibility for thrombolysis for patients suffering myocardial infarction. The aims of this study were to evaluate the role of the 15-lead electrocardiogram in the emergency department chest ...
Dilley S - - 2001
OBJECTIVE: To determine whether the introduction of acute angioplasty referral guidelines would lead to an improvement in decision-making times with respect to thrombolysis for patients with acute myocardial infarction. METHODS: Retrospective and prospective collection of 'time from diagnostic electrocardiogram to treatment' for all patients who received thrombolytic treatment for acute ...
Kucia A M - - 2001
OBJECTIVE: The goal of this study was to determine the effect of a coronary care-trained nurse (CCTN) on transfer times of patients presenting with acute coronary syndromes (ACS) from the emergency department (ED) to the coronary care unit (CCU) for definitive cardiac treatment (DCT). DESIGN: This was a prospective randomized ...
Siegel R J - - 2001
Previous studies have shown that external ultrasound with low frequencies and high intensities can enhance thrombolytic drug-induced clot dissolution during in vitro experiments. In this series of studies, we evaluated the efficacy of peripheral and coronary thrombolysis in vivo in animals by using noninvasive transcutaneous ultrasound combined with thrombolytic drugs ...
Behrens S - - 2001
Systemic treatment with rtPA approved for a 3-hour window is the only established causal therapy for acute stroke in the United States and Canada. Thrombolytic therapy with rtPA demonstrated a small, although significantly reduced morbidity, in a limited number of highly selected patients. As recently shown, intraarterial application is favorable ...
Ogasawara K - - 2001
The aim of this study was to investigate the prognostic utility of post-treatment technetium-99m ethyl cysteinate dimer (99mTc-ECD) single-photon emission tomography (SPET) for predicting ischemic tissue outcome in cases involving embolic middle cerebral artery occlusion treated with local intra-arterial thrombolysis. We examined twenty-five patients with a moderately ischemic area determined ...
Vrachatis A D - - 2001
Following thrombolysis and primary percutaneous transluminal coronary angioplasty (PTCA) for acute ST segment elevation myocardial infarction, basal flow in the culprit artery is known to influence prognosis. The purpose of this study was to determine if differences exist in basal flow in culprit and nonculprit coronary arteries in patients with ...
Gibson C M - - 2001
The establishment of patency (Thrombolysis In Myocardial Infarction [TIMI] grade 2 or 3 flow) and/or TIMI grade 3 flow at 60 minutes after thrombolytic administration is both a univariate and multivariate predictor of in-hospital and 30-day mortality, and the odds ratios for mortality are nearly identical for TIMI grade 3 ...
Rosenschein Uri - - 2001
During high-power ultrasound irradiation in fluids, microbubbles are formed and collapse to generate shock waves and induce fibrinolysis. In vivo, intracoronary injection of ultrasound-lysed clots increased myocardial perfusion. The experience with the ultrasound thrombolysis catheter in the ACUTE (Analysis of Coronary Ultrasound Thrombolysis Endpoints) trial showed that primary percutaneous coronary ...
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