Search

Your search keyword '"adverse effects [Fibrinolytic Agents]"' showing total 4 results
Start Over Descriptor "adverse effects [Fibrinolytic Agents]"
4 results on '"adverse effects [Fibrinolytic Agents]"'

1. Early effect of thrombolysis on structural brain network organisation after anterior-circulation stroke in the randomized WAKE-UP trial

Author

Eckhard Schlemm, Märit Jensen, Amy Kuceyeski, Keith Jamison, Thies Ingwersen, Carola Mayer, Alina Königsberg, Florent Boutitie, Martin Ebinger, Matthias Endres, Jochen B. Fiebach, Jens Fiehler, Ivana Galinovic, Robin Lemmens, Keith W. Muir, Norbert Nighoghossian, Salvador Pedraza, Josep Puig, Claus Z. Simonsen, Vincent Thijs, Anke Wouters, Christian Gerloff, Götz Thomalla, Bastian Cheng, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Weill Cornell Medicine [Cornell University], Cornell University [New York], University Hospital Hamburg-Eppendorf, Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Medical Park Berlin Humboldtmühle [Berlin, Germany] (MPBH), German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University Hospitals Leuven [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Leuven Center for Cancer Biology (VIB-KU-CCB), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-Vlaams Instituut voor Biotechnologie [Ghent, Belgique] (VIB), University of Glasgow, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta - Girona Biomedical Research Institute (IDIBGI), Girona Biomedical Research Institute [Girona, Spain] (IDIBGI), Aarhus University Hospital, University of Melbourne, Austin Hospital [Melbourne], Austin Health, Amsterdam UMC - Amsterdam University Medical Center, Weill Cornell Medicine [New York], Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and CarMeN, laboratoire

Subjects
[SDV.BA] Life Sciences [q-bio]/Animal biology, RECANALIZATION, Neuroimaging, CONNECTOME, Brain Ischemia, Fibrinolytic Agents, CONNECTIVITY, therapeutic use [Fibrinolytic Agents], diagnostic imaging [Stroke], ischemic stroke, systemic thrombolysis, Humans, Thrombolytic Therapy, Radiology, Nuclear Medicine and imaging, structural connectivity, ACUTE ISCHEMIC-STROKE, ddc:610, diagnostic imaging [Brain], adverse effects [Tissue Plasminogen Activator], Science & Technology, Radiological and Ultrasound Technology, network neuroscience, [SDV.BA]Life Sciences [q-bio]/Animal biology, Radiology, Nuclear Medicine & Medical Imaging, Neurosciences, Brain, ASSOCIATION, methods [Thrombolytic Therapy], RECOVERY, adverse effects [Fibrinolytic Agents], COGNITIVE IMPAIRMENT, REGIONS, adverse effects [Thrombolytic Therapy], DYSFUNCTION, drug therapy [Stroke], Stroke, therapeutic use [Tissue Plasminogen Activator], Treatment Outcome, Neurology, TISSUE, diagnostic imaging [Brain Ischemia], Tissue Plasminogen Activator, drug therapy [Brain Ischemia], Neurosciences & Neurology, Neurology (clinical), Anatomy, Life Sciences & Biomedicine
Abstract

The symptoms of acute ischemic stroke can be attributed to disruption of the brain network architecture. Systemic thrombolysis is an effective treatment that preserves structural connectivity in the first days after the event. Its effect on the evolution of global network organisation is, however, not well understood. We present a secondary analysis of 269 patients from the randomized WAKE-UP trial, comparing 127 imaging-selected patients treated with alteplase with 142 controls who received placebo. We used indirect network mapping to quantify the impact of ischemic lesions on structural brain network organisation in terms of both global parameters of segregation and integration, and local disruption of individual connections. Network damage was estimated before randomization and again 22 to 36 h after administration of either alteplase or placebo. Evolution of structural network organisation was characterised by a loss in integration and gain in segregation, and this trajectory was attenuated by the administration of alteplase. Preserved brain network organization was associated with excellent functional outcome. Furthermore, the protective effect of alteplase was spatio-topologically nonuniform, concentrating on a subnetwork of high centrality supported in the salvageable white matter surrounding the ischemic cores. This interplay between the location of the lesion, the pathophysiology of the ischemic penumbra, and the spatial embedding of the brain network explains the observed potential of thrombolysis to attenuate topological network damage early after stroke. Our findings might, in the future, lead to new brain network-informed imaging biomarkers and improved prognostication in ischemic stroke. ispartof: HUMAN BRAIN MAPPING vol:43 issue:16 pages:5053-5065 ispartof: location:United States status: published

Published
2022

2. Different Mismatch Concepts for Magnetic Resonance Imaging–Guided Thrombolysis in Unknown Onset Stroke

Author

Matthias Endres, Jochen B. Fiebach, Anke Wouters, Bastian Cheng, Soren Christensen, Robin Lemmens, Christian Gerloff, Patrick Dupont, Keith W. Muir, Martin Ebinger, Salvador Pedraza, Florent Boutitie, Claus Z Simonsen, Götz Thomalla, Norbert Nighoghossian, Vincent Thijs, Lauranne Scheldeman, University Hospitals Leuven [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Flanders Make [Leuven], Flanders Make, Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), GrayNumber Analytics [Lomma, Sweden], Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University of Glasgow, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospital Universitari de Girona Doctor Josep Trueta [Girona, Spain], Aarhus University Hospital, Florey Institute of Neuroscience and Mental Health [Melbourne, Victoria, Australia], Austin Health, WAKE-UP Investigators, CarMeN, laboratoire, Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_treatment, Image Processing, [SDV]Life Sciences [q-bio], Perfusion scanning, Fluid-attenuated inversion recovery, Brain Ischemia, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Modified Rankin Scale, methods [Image Processing, Computer-Assisted], Image Processing, Computer-Assisted, therapeutic use [Fibrinolytic Agents], diagnostic imaging [Stroke], Thrombolytic Therapy, Stroke, medicine.diagnostic_test, Thrombolysis, adverse effects [Fibrinolytic Agents], Middle Aged, 3. Good health, drug therapy [Stroke], [SDV] Life Sciences [q-bio], therapeutic use [Tissue Plasminogen Activator], Treatment Outcome, Neurology, Tissue Plasminogen Activator, Predictive value of tests, Cardiology, drug therapy [Brain Ischemia], Tissue Plasminogen Activator/adverse effects/therapeutic use, Female, WAKE-UP Investigators, medicine.medical_specialty, Perfusion Imaging, 03 medical and health sciences, Fibrinolytic Agents, Double-Blind Method, Predictive Value of Tests, Internal medicine, Stroke/*diagnostic imaging/*drug therapy, medicine, Humans, cardiovascular diseases, ddc:610, Fibrinolytic Agents/adverse effects/therapeutic use, adverse effects [Tissue Plasminogen Activator], Aged, Thrombolytic Therapy/adverse effects/*methods, business.industry, Magnetic resonance imaging, methods [Thrombolytic Therapy], medicine.disease, adverse effects [Thrombolytic Therapy], Confidence interval, Computer-Assisted/*methods, Brain Ischemia/diagnostic imaging/drug therapy, Diffusion Magnetic Resonance Imaging, diagnostic imaging [Brain Ischemia], Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

OBJECTIVE: To explore the prevalence of the perfusion-weighted imaging (PWI)-diffusion-weighted imaging (DWI) mismatch and response to intravenous thrombolysis in the WAKE-UP trial. METHODS: We performed a prespecified post hoc analysis of ischemic stroke patients screened for DWI-fluid-attenuated inversion recovery (FLAIR) mismatch in WAKE-UP who underwent PWI. We defined PWI-DWI mismatch as ischemic core volume 10ml, and mismatch ratio > 1.2. Primary efficacy end point was a modified Rankin Scale score of 0-1 at 90 days, adjusted for age and symptom severity. RESULTS: Of 1,362 magnetic resonance imaging-screened patients, 431 underwent PWI. Of these, 57 (13%) had a double mismatch, 151 (35%) only a DWI-FLAIR mismatch, and 54 (13%) only a PWI-DWI mismatch. DWI-FLAIR mismatch was more prevalent than PWI-DWI mismatch (48%, 95% confidence interval [CI] = 43-53% vs 26%, 95% CI = 22-30%; p

Published
2020

3. Successful mechanical thrombectomy in stroke with thrombolysis-associated intracerebral hemorrhage—a case report

Author

Gabor C. Petzold, Elke Hattingen, Johannes Weller, and Felix J. Bode

Subjects
Male, Computed Tomography Angiography, medicine.medical_treatment, Infarction, methods [Cerebral Angiography], 0302 clinical medicine, methods [Thrombectomy], administration & dosage [Fibrinolytic Agents], Occlusion, surgery [Cerebral Hemorrhage], Thrombolytic Therapy, Infusions, Intravenous, Stroke, Thrombectomy, Rehabilitation, etiology [Infarction, Middle Cerebral Artery], Infarction, Middle Cerebral Artery, Thrombolysis, adverse effects [Fibrinolytic Agents], Magnetic Resonance Imaging, diagnostic imaging [Cerebral Amyloid Angiopathy], Treatment Outcome, Cardiology, complications [Cerebral Amyloid Angiopathy], Cerebral amyloid angiopathy, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, 03 medical and health sciences, Fibrinolytic Agents, Internal medicine, medicine, Humans, ddc:610, drug therapy [Infarction, Middle Cerebral Artery], Aged, Cerebral Hemorrhage, Intracerebral hemorrhage, business.industry, chemically induced [Cerebral Hemorrhage], diagnostic imaging [Infarction, Middle Cerebral Artery], diagnostic imaging [Cerebral Hemorrhage], adverse effects [Thrombolytic Therapy], medicine.disease, Cerebral Angiography, Cerebral Amyloid Angiopathy, Hemiparesis, Surgery, Neurology (clinical), Complication, business, 030217 neurology & neurosurgery
Abstract

Background Intravenous thrombolysis and mechanical thrombectomy are the standard of care for patients with acute ischemic stroke with large vessel occlusion. Intracerebral hemorrhage is a main complication of intravenous thrombolysis, however, no data are available on the efficacy and safety of mechanical thrombectomy in patients with thrombolysis-associated intracerebral hemorrhage. This constellation is expected to become more frequent as increasing numbers of patients are treated under the drip-and-ship paradigm. Case report A 75-year-old male patient was admitted to an emergency department with acute onset dysarthria and left side hemiparesis due to right middle cerebral artery occlusion. Intravenous thrombolysis was initiated and the patient transferred to our center for mechanical thrombectomy. Upon arrival, cerebral imaging showed persistent right middle cerebral artery occlusion and new onset left frontal, temporal, and parietal intracerebral hemorrhage. Thrombectomy was performed and perfusion completely re-established with excellent neurological outcome. Follow-up imaging revealed probable cerebral amyloid angiopathy. Conclusion Mechanical thrombectomy may be safe and effective in ischemic stroke with large vessel occlusion and thrombolysis-associatied intracerebral hemorrhage.

Published
2019

4. Temporal Trends in Pharmacological Stroke Prevention in Patients with Acute Ischemic Stroke and Known Atrial Fibrillation

Author

Maria Konieczny, Karl Georg Haeusler, Ulrike Grittner, Juliane Herm, Rudi Ruschmann, Matthias Endres, and Simon Hellwig

Subjects
Male, trends [Secondary Prevention], Time Factors, prevention & control [Brain Ischemia], Administration, Oral, Brain Ischemia, 0302 clinical medicine, Risk Factors, administration & dosage [Fibrinolytic Agents], Germany, diagnosis [Brain Ischemia], Atrial Fibrillation, Antithrombotic, Secondary Prevention, drug therapy [Atrial Fibrillation], Practice Patterns, Physicians', adverse effects [Anticoagulants], Stroke, Acute ischemic stroke, Stroke etiology, Aged, 80 and over, Ischemic stroke, Rehabilitation, Atrial fibrillation, adverse effects [Fibrinolytic Agents], diagnosis [Stroke], trends [Practice Patterns, Physicians'], Treatment Outcome, administration & dosage [Anticoagulants], Stroke prevention, Cardiology, Female, adverse effects [Platelet Aggregation Inhibitors], Cardiology and Cardiovascular Medicine, epidemiology [Stroke], prevention & control [Stroke], epidemiology [Atrial Fibrillation], medicine.medical_specialty, epidemiology [Germany], Non-vitamin K-dependent oral anticoagulants, 03 medical and health sciences, Fibrinolytic Agents, Internal medicine, medicine, Hospital discharge, epidemiology [Brain Ischemia], Humans, In patient, ddc:610, Medical prescription, Secondary stroke prevention, Aged, Retrospective Studies, business.industry, diagnosis [Atrial Fibrillation], administration & dosage [Platelet Aggregation Inhibitors], Anticoagulants, medicine.disease, Drug Utilization, Surgery, Neurology (clinical), trends [Drug Utilization], business, Platelet Aggregation Inhibitors, 030217 neurology & neurosurgery
Abstract

Oral anticoagulation (OAC) substantially reduces stroke risk in patients with atrial fibrillation (AF) at risk for stroke. Whether non-vitamin K-dependent oral anticoagulants (NOACs) improve OAC use in stroke prevention requires investigation.To investigate temporal trends of OAC use in patients with known AF pre-stroke, we retrospectively analyzed records of 6,803 stroke patients admitted in 2003-2004 (n=1,496), 2008-2010 (n=1,638) or 2013-2015 (n=3,669) to the Charité-Universitätsmedizin Berlin, Germany. Adjusted regression models were used to identify factors associated with OAC use.Of 1,209 AF patients (mean age 79 years, 55.9% female) with given indication for OAC according to the CHADS2/CHA2DS2-VASc score, 484 (40.0%) were anticoagulated prior to the index stroke, 458 (37.9%) received antiplatelets and 236 (19.5%) had no antithrombotic medication. Compared to 2003-2004 and 2008-2010, there was a higher rate of pre-admission OAC in 2013-2015 (28.2% vs. 49.6%, p

Published
2020

Catalog

Books, media, physical & digital resources
See catalog results