Despite major advances made over the last decade, mortality following acute myocardial infarction (MI) is still high even for patients treated with the "front-loaded" recombinant tissue-type plasminogen activator (rt-PA) regimen: 30-day mortality is 6.3%, and it is associated with fatal cerebral hemorrhage in 1.5%. Further improvement of short- and long-term prognosis can be achieved if infusio...

OBJECTIVE To provide a comprehensive and latest overview of susceptibility-weighted imaging (SWI) in the application of thrombolysis in acute ischemic stroke, and to update the decision-making effect and clinical value of SWI on identifying stroke patients suitable for thrombolytic therapy and possible benefits and risks followed. DATA SOURCES Literatures referred to this review were collecte...

The important role of reperfusion therapies in the treatment of acute myocardial infarction is well documented. However, reperfusion therapies can initiate inflammatory response and may damage the myocardium. The purpose of current study was to compare the effects of percutaneous coronary intervention and thrombolytic therapy on inflammatory markers in the setting of ST elevation myocardial inf...

Thrombolysis and primary angioplasty are both recommended reperfusion strategies for elderly patients presenting with myocardial infarction (MI). Primary angioplasty is most beneficial in high-risk patients. While the elderly have a high absolute risk of dying or developing complications after MI, they also have an increased risk of intracranial haemorrhage if they are given thrombolytic therap...

BACKGROUND Long-term central venous catheters have improved the quality of care for patients with chronic illnesses, but are complicated by obstructions which can result in delay of treatment or catheter removal. DESIGN AND METHODS This paper reviews thrombolytic treatment for catheter obstruction. Literature from Medline searches using the terms "central venous catheter", "central venous acc...

Why Are Stroke Physicians Uncertain of the Benefits of Early tPA? An independent national survey1 of 1716 stroke physicians in the United Kingdom reported that 74% were uncertain of the benefits of thrombolytic therapies. A recent United States survey2 reported that less than half of the responding neurologists had administered tPA and only 30% believed the efficacy of intravenous tPA was “very...

Computed tomography (CT) is the current standard for time-critical decision-making in stroke patients, informing decisions on thrombolytic therapy with tissue plasminogen activator (tPA), which has a narrow therapeutic index. We aimed to develop a CT-based method to directly visualize cerebrovascular thrombi and guide thrombolytic therapy. Glycol-chitosan-coated gold nanoparticles (GC-AuNPs) we...

BACKGROUND Cardiovascular diseases are the major causes of mortality worldwide and acute myocardial infarction (AMI) is the leading cause of mortality among cardiovascular diseases. Thrombolytic therapies, especially during the first few hours after the disease onset, can significantly reduce AMI-related mortality. METHODS The current study aimed to determine the prevalence and causes of non-...

BACKGROUND AND PURPOSE Prior use of antiplatelet agents improves stroke outcome in patients undergoing thrombolytic therapy as shown by reduced arterial reocclusion, although the risk of cerebral hemorrhage can be increased. METHODS The effect of cilostazol, an antiplatelet drug that improves endothelial function through upregulation of intracellular cAMP, on cerebral hemorrhage after thrombo...

BACKGROUND AND PURPOSE Intracranial hemorrhage is a serious complication of thrombolytic therapy for acute myocardial infarction, especially among the elderly, but little information exists on estimating risk. Better estimation of risk in individual patients may allow for withholding or using alternate therapies among those at highest risk. METHODS To quantify the risk and identify predictors...