PURPOSE To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administratio...

BACKGROUND AND PURPOSE It remains unknown whether the effects of 0.6 mg/kg alteplase differ with occlusion site of the middle cerebral artery (MCA). We therefore evaluated the effects of 0.6 mg/kg intravenous alteplase in patients with different sites of MCA occlusion. METHODS An exploratory analysis was made of 57 patients enrolled in the Japan Alteplase Clinical Trial II (J-ACT II), origina...

According to the guidelines of the European Stroke Organization (ESO) and the American Stroke Association (ASA), acute stroke patients should be managed at stroke units that include well organized pre- and in-hospital care. In ischemic stroke the restoration of blood flow has to occur within a limited time window that is accomplished by fibrinolytic therapy. Newer generation thrombolytic agents...

BACKGROUND Intravenous alteplase for acute ischemic stroke is least efficacious for patients with proximal large-artery occlusions and clinically severe strokes. Intra-arterial therapy has the theoretical advantage of establishing a neurovascular diagnosis and high symptomatic artery patency rate but the disadvantage of requiring extra time and technical expertise. A combination of these two ap...

BACKGROUND AND PURPOSE In Japan, alteplase at 0.6 mg/kg was approved in October 2005 for use within 3 hours of stroke onset by the Ministry of Health, Labor and Welfare (MHLW). The aim of the Japan post-Marketing Alteplase Registration Study (J-MARS), which was requested by MHLW at the time of approval, was to assess the safety and efficacy of 0.6 mg/kg alteplase in routine clinical practice fo...

BACKGROUND AND PURPOSE Because of the risk of hemorrhage, especially in the brain, thrombolytic therapy with intravenous alteplase is restricted by guidelines, and only a small number of selected patients are being treated. Findings from metaanalyses, post hoc analyses of the randomized trials, and postlicensing experience suggest that more subjects, who otherwise have a poor predicted outcome ...

Background and Purpose—The aim of the current study was to investigate the dose-dependent efficacy of intraventricular fibrinolysis (IVF) in patients with severe intraventricular hemorrhage (IVH). Methods—Patients with intracerebral hemorrhage, severe IVH, and obstructive hydrocephalus with the need for external ventricular drainage were treated with IVF through external ventricular drainage. T...

In patients with massive pulmonary embolism threatened by haemodynamic instability, thrombolytic treatment is recommended. But when it fails, therapeutic options remain limited and are mainly guided by local expertise. In the current case, we report a potential treatment modality for this situation. A 60-year-old male patient collapsed several times at home. He had a history of a curative left ...

Background: Underlying pathophysiology of posterior capsule opacification, a frequent visual disturbance postop complication cataract surgery, is multifactorial. Several cytokines and growth factors, such as Transforming Growth Factor-? (TGF-?), Fibroblast Factor 2 (FGF2), Hepatocyte (HGF), have been found to play roles in the formation PCO. Multiple advancements made including researches thera...

BACKGROUND The cerebrovascular accident (CVA) or stroke is the main cause of death in Brazil and little information is available on the cost of treatment. OBJECTIVE To carry out a cost-effectiveness analysis of thrombolysis in stroke, up to three hours after symptom onset, comparing the treatment with alteplase versus the conservative treatment, under the perspective of the Brazilian Public H...