BACKGROUND The aim of the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) was to assess the safety and efficacy of intravenous alteplase as thrombolytic therapy within the first 3 h of onset of acute ischaemic stroke. Under European Union regulations, SITS-MOST was required to assess the safety profile of alteplase in clinical practice by comparison with results in ra...

Background and Purpose—Iodinated contrast is increasingly used in CT perfusion or angiographic examinations in acute stroke. Increased risk of intracranial hemorrhage (ICH) complicating microcatheter contrast injections has recently been reported in the second Interventional Management of Stroke (IMS 2) trial with contrast toxicity potentially contributory. Methods—We reviewed clinical and radi...

PURPOSE To compare the efficacy, safety, and costs associated with catheter-directed thrombolysis with urokinase (UK) and the recombinant agents alteplase (tissue plasminogen activator [TPA]) and reteplase (recombinant plasminogen activator [RPA]) in the treatment of symptomatic deep vein thrombosis (DVT). MATERIALS AND METHODS The authors conducted a retrospective analysis on 74 patients (82...

Catheter‐directed thrombolysis (CDT) has emerged as a potential management option for proximal deep vein thrombosis (DVT). Low‐dose alteplase with concomitant heparin have traditionally been used in this setting. Patients with heparin‐induced thrombocytopenia (HIT) undergoing CDT pose a challenge since heparin would be contraindicated. Robust evidence regarding use of direct thrombin inhibitors...

Background and Purpose: Quantitating the effect of intravenous alteplase on technical outcome early recanalization large vessel occlusions aids understanding. We report prevalence in patients with stroke because occlusion treated without endovascular thrombectomy, its association clinical outcome. Methods: Patients acute ischemic from ESCAPE trial (Endovascular Treatment for Small Core Anterior...

O ver the past 2 years, the results of large clinical trials have fundamentally changed the clinical practice of stroke care in several different ways. Perhaps the greatest advances have occurred in stroke prevention, where we now have a wider array of anticoagulants to reduce the risk of stroke in patients with atrial fibrillation and we have confirmation from 2 large studies that medical ther...

ALI = acute limb ischemia, APSAC = antistreplase, MTD = mechanical thromboembolectomy device, PAT = percutaneous aspiration thromboembolectomy, pro-UK = prourokinase, RPA = reteplase, r-UK = recombinant urokinase, SK = streptokinase, STILE = Surgery versus Thrombolysis for Ischemia of the Lower Extremity [study], tPA = tissue plasminogen activator, TOPAS = Thrombolysis or Peripheral Arterial Su...

BACKGROUND AND PURPOSE Ischemic stroke patients with regional very low cerebral blood volume (VLCBV) on baseline imaging have increased risk of parenchymal hemorrhage (PH) after intravenous alteplase-induced reperfusion. We developed a method for automated detection of VLCBV and examined whether patients with reperfused-VLCBV are at increased risk of PH after endovascular reperfusion therapy. ...

Background and Purpose—Because of the narrow therapeutic range for thrombolysis in stroke, accurate weight-based dosing is essential for efficacy and safety. Stroke patients are frequently incapable to communicate their correct body weight (BW). Thus, dosing is often based on BW estimation, which may lead to dosing errors. The aim of our study was to evaluate availability of BW information, acc...