BACKGROUND Central venous catheter (CVC) occlusion is common, affecting 30% of all CVCs. OBJECTIVE To compare length of stay (LOS), costs, and readmissions associated with the use of alteplase to clear catheter blockage to outcomes associated with catheter replacement. DESIGN Retrospective observational study utilizing a large hospital database. PARTICIPANTS Hospitalized patients treated ...

BACKGROUND AND PURPOSE Two phase 2 studies of alteplase in acute ischemic stroke 3 to 6 hours after onset, Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET; a randomized, controlled, double-blinded trial), and Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution Study (DEFUSE; open-label, treatment only) using MR imaging-based outcomes have been conducted. We h...

In this study, we examined the effects of alteplase, a recombinant tissue-type plasminogen activator (t-PA), in a simple and reproducible rat middle cerebral artery (MCA) occlusion model induced by photoillumination with 12 mg/kg of rose bengal. A clinically equivalent dose of alteplase (3 mg/kg), which was administered just after thrombotic occlusion of the MCA, significantly reopened the thro...

The publication of the National Institute of Neurological Disorders and Stroke trial of thrombolysis has not led to the widespread implementation of alteplase for acute ischaemic stroke in the United Kingdom. However, the Cochrane systematic review of thrombolysis for acute ischaemic stroke suggests that alteplase is the most promising treatment for acute ischaemic stroke. Successful implementa...

There are essentially 2 widely accepted approaches to the statistical analysis of acute stroke outcome data. One may focus solely on good versus bad outcome, disregarding further details of the patient’s functional status. Thus, one may consider patients with an excellent outcome to be of equal value to those with a good outcome but otherwise patients left Background—Thrombolytic therapy with i...

INTRODUCTION Alteplase and tenecteplase are two widely used thrombolytic agents and are both approved for the treatment of acute myocardial infarction. These two molecules have increased fibrin specificity compared with older thrombolytics but distinct pharmacokinetic properties and may differ in terms of risks and benefits. We decided to review the available evidence comparing the safety and e...

BACKGROUND Thrombolytic therapy in patients with acute myocardial infarction (AMI) is hampered by procoagulant effects. In vitro studies have indicated that plasmin stimulation activates the kallikrein-contact-phase system, resulting in thrombin activation. This prospective comparative study was designed to examine the procoagulant effects of streptokinase or alteplase in AMI. METHODS AND RES...

PURPOSE To evaluate the efficacy, safety, and results of direct thrombolytic therapy in intracranial dural sinus thrombosis by infusion of alteplase (recombinant tissue plasminogen activator). METHODS Nine patients were treated during a 2-year period for intracranial dural sinus thrombosis. A microcatheter was placed directly into the thrombus in the dural sinus via the transfemoral route. Th...

Plasma levels of plasminogen activator inhibitor type-1 (PAI-1), beta-thromboglobulin (beta TG), and fibrinopeptide A (FPA) were followed over 24 hours in 30 patients treated with alteplase for acute myocardial infarction. Samples were taken at baseline (T Oh), after 90 minutes (under alteplase, no heparin, T 1.5h), after 120 minutes (under alteplase and heparin, T 2h), 30 minutes after thrombo...