Articles Tagged With: stroke
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Telestroke Facilitates Care for Rural Stroke Patients
In the year before the telestroke program was implemented, 11 of 15 eligible patients received thrombolytics in less than one hour, and there was a mean door-to-needle time of 61 minutes. After the telestroke program was implemented, 11 of 12 eligible patients received thrombolytics in less than one hour, with a mean door-to-needle time of just 38 minutes.
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Searching for a Neuroprotective Agent in Celery Seed Oil
A Phase III double-blind, placebo-controlled, randomized, controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Timing of Anticoagulation Administration Following Atrial Fibrillation-Associated Stroke
A prospective, blinded, randomized study of early vs. later administration of oral anticoagulation after ischemic stroke in patients with atrial fibrillation calibrated by cerebral imaging showed no significant difference in 30-day outcomes.
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Blood Pressure Management After Endovascular Thrombectomy: What Is the Best Number?
Approximately 50% of patients who undergo endovascular therapy for ischemic stroke still have a severe impairment or will die within 90 days. Therefore, additional interventions are being investigated to improve overall outcome. Current guidelines from the American Heart Association suggest maintaining systolic blood pressure below 180 mmHg for patients who were treated both with intravenous thrombolysis and endovascular thrombectomy. A number of centers around the world have tried different systolic blood pressure thresholds ranging from 120 mmHg to 160 mmHg. Many of these studies have been single-center or small non-randomized studies and have not been designed to get a definitive answer.
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Tenecteplase vs. Alteplase for Treatment of Acute Ischemic Stroke: It Is Time to Make the Change
Since 1996, when the U.S. Food and Drug Administration approved the use of intravenous alteplase for the treatment of acute ischemic stroke, there has been a steady increase in the adoption of both intravenous thrombolysis as well as endovascular thrombolysis and mechanical thrombectomy for the treatment of patients with acute ischemic stroke and large vessel occlusion. There now is extensive experience with the use of tenecteplase for the treatment of acute ischemic stroke. It has been shown to be equally efficacious, with a similar risk profile as alteplase.
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Statins Might Lower Risk of Recurrent Stroke
Patients in Denmark who suffered an intracerebral hemorrhage and were taking cholesterol-lowering medication were less likely to experience another stroke.
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Lawsuits Allege Delays, Failure to Treat with Mechanical Thrombectomy
Malpractice claims involving intravenous thrombolytic therapy to treat acute ischemic stroke patients are more likely to allege failure to treat than to allege complications related to therapy. A group of researchers wanted to know if the same was true regarding mechanical thrombectomy.
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Differentiating MELAS from Bland Ischemic Stroke: Clinicoradiologic Criteria
Stroke symptoms in mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) are difficult to diagnose correctly, which leads to missed opportunities to provide MELAS-specific treatment. Delay in diagnosis also complicates efforts to investigate acute treatments for MELAS. Khasminsky et al proposed clinicoradiologic criteria based on a single-center validation study. Although there are methodological limitations, the concepts highlighted by the authors are valuable.
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Stroke Patient Navigator Prevents 30-Day Readmissions
A stroke nurse navigator team can prevent 30-day readmissions in stroke patients treated with thrombolysis, investigators found. A health system’s 30-day readmission rate was 13.6% before it began to use a stroke nurse navigator. The rate declined to 6.9%. Patients with the stroke nurse implementation were 67.6% less likely to be readmitted within 30 days compared to patients without the navigator.
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Endovascular Thrombectomy for Large Ischemic Core Strokes
Endovascular thrombectomy has been rapidly adopted throughout the world for the treatment of patients with acute ischemic stroke and large vessel occlusion. This approach has achieved strong recommendations in stroke guidelines. However, the trials that form the basis of the recommendations have strict imaging recruitment criteria.