Theory, experiment, and common sense all suggest that the earlier thrombolysis is given for acute myocardial infarction, the greater should be the benefit. We would expect the time-effect, i.e. the increased efficacy of thrombolytic therapy with earlier administration, to be very powerful, and of immense clinical importance. However, from randomized clinical trials it appears that the benefit o...

BACKGROUND To investigate the efficacy, safety, and patency following treatment of wall-adherent thrombus in hemodialysis vascular access with a wall-contact device, the Arrow-Trerotola percutaneous thrombolytic device (PTD). METHODS We retrospectively reviewed an existing database of procedures fulfilling the following criteria: thrombosed hemodialysis access, wall-adherent thrombus, and use...

The developing world carries the highest burden of stroke mortality and stroke-related disability. The number of stroke patients receiving r-tPA in the developing world is extremely low. Prehospital delay, financial constraints, and lack of infrastructure are main barriers of thrombolysis therapy in developing countries. Until a cheaper thrombolytic agent and the proper infrastructure for utili...

In order to design plasminogen activators with improved thrombolytic properties, bifunctional proteins with both plasminogen-activating and anticoagulative activity were constructed by fusing a thrombin-inhibitory moiety itself comprises four elements: linker 1, a motif directed to thrombin's active site, linker 2 and a fragment of hirudin which binds to the fibrinogen-recognition site of throm...

Since the earliest days of the thrombolytic era, maximizing myocardial salvage by reperfusion of the myocardial region at risk for myocardial infarction has been the most important immediate objective in management of ST-segment elevation myocardial infarction (STEMI) (1). The roles of time to reperfusion and collateral flow to the infarct territory and their impact on early and late post-infar...

This article about new anticoagulant drugs is part of the seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines. The limitations of existing oral and parenteral anticoagulant agents have prompted a search for novel agents. Focusing on new anticoagulant drugs for the prevention and treatment of arterial and venous thrombosis...

Acute revascularization is associated with improved outcomes in ischemic stroke patients. It is unclear which method of intra-arterial intervention, if any, is ideal. Promising approaches in acute stroke treatment are likely a combination of intravenous and endovascular revascularization efforts, combining early treatment initiation with direct clot manipulation and/or PTA/stenting. In this rev...

Use of the Boersma curve in order to describe the beneficial effect of thrombolytic treatment at different treatment delays seems questionable, because the curve may underestimate the favourable prognostic effects of early thrombolysis in patients with acute myocardial infarction

Recently, a number of developments in the acute management of stroke have necessitated active involvement of neurocritical care. This review focuses on the immediate care, including intensive care, that may make a difference to the patient outcome. Recent research, that highlights the importance of acute management of stroke in terms of thrombolysis, thrombolytic agents, decompressive surgery, ...