Thrombolytic Therapy for Stroke

Thrombolytic Therapy for Stroke PDF

Author: Patrick D. Lyden

Publisher: Springer Science & Business Media

Published: 2001-02-23

Total Pages: 398

ISBN-13: 1592591310

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Thrombolytic Therapy for Stroke is intended for physicians who will be treating patients in the first few hours after stroke: neurologists, neurosurgeons, emergency medicine physicians, internists, and radiologists. In some areas, fam ily medicine general practice physicians may provide the majority of acute stroke care. We will provide the reader with all the data necessary to understand the utility and limitations of thrombolytic therapy. By reading the protocols, and working through the case tutorials, the reader will become sufficiently familiar with the indications and contraindications of thrombolytic therapy to begin evalu ating potential patients. Although nothing can replace direct instruction by more experienced physicians, we hope that by imparting our accumulated knowledge we may guide those physicians who cannot attend a "hands-on" workshop, or who, having heard the appropriate lectures, feel the need for further guidance. We will review the scientific rationale for thrombolysis: first, most ischemic stroke is caused by thrombo-emboli; second, a portion of brain, the penumbra, remains salvageable for a few hours after vascular occlusion; and third, promptly delivered thrombolysis can remove the offending occlusion and restore cerebral blood flow to the penumbra in time to salvage brain and neurologic function. Then we will review the preclinical development of thrombolytics for stroke pa tients and the early pilot trials. Next, we will present the pivotal clinical trials that demonstrated the efficacy and safety of thrombolysis.

Thrombolytic Therapy for Acute Stroke

Thrombolytic Therapy for Acute Stroke PDF

Author: Patrick D. Lyden

Publisher: Springer Science & Business Media

Published: 2005-03-24

Total Pages: 372

ISBN-13: 158829398X

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Annotation The world's leading experts detail the basic rationale, scientific evidence, and treatment protocol for thrombolytic therapy in acute stroke patients. Thoroughly revised and updated, these experienced clinicians show how promptly delivered thrombolysis can restore cerebral blood flow in time to salvage brain and neurologic functions. New chapters cover topics such as the newer thrombolytics (TNK, desmoteplase, and reteplase, MRI imaging to guide thrombolytics, new content on intr-arterial and comibed IV/IA therapies, as well as new clinical cases covering the real-life use of throbolytics. Their description of the treatment protocol discusses field triage and management, emergency department therapy, brain imaging, clinical decision making and patient selection, drug administration, post-thrombolysis management, and the treatment of complications.

Thrombolytic Therapy for Acute Stroke

Thrombolytic Therapy for Acute Stroke PDF

Author: Patrick D. Lyden

Publisher: Springer Science & Business Media

Published: 2007-11-08

Total Pages: 392

ISBN-13: 1592599338

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It often takes time for a new therapeutic modality to mature into an accepted treatment option. After initial approval, new drugs, devices, and procedures all go through this process until they become “vetted” by the scientific community as well as the medical community at large. Thrombolysis for treatment of stroke is no exception. Thrombolytic Therapy for Acute Stroke, Second Edition comes four years after the first edition and provides a very comprehensive, updated perspective on the use of intravenous rt-TPA in acute stroke. The authors provide longer term follow-up on the pivotal clinical trials that led to Food and Drug Administration approval, data concerning phase 4 trials in larger numbers of patients, and, most importantly, the community experience that has accumulated since its release. They add to this the latest promising information concerning intra-arterial thrombolysis, which is still under investigation and more speculative sections concerning possible new avenues of clinical research such as combining intravenous thr- bolysis with neuroprotective therapies or intra-arterial thrombolysis. A wealth of factual information is supplemented by chapters containing sage opinion from Drs. Lyden and Caplan concerning the logistical, economic, and procedural issues that have been generated since the advent of this technology. Importantly, diagnosis does not take a back seat to therapeutics as illustrated by sections devoted to eva- ation of the stroke patient, very useful illustrative cases and clinical comments, and chapters on the latest in imaging as applied to this field.

Acute Ischemic Stroke

Acute Ischemic Stroke PDF

Author: R. Gilberto González

Publisher: Springer Science & Business Media

Published: 2010-10-05

Total Pages: 299

ISBN-13: 3642127517

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This updated second edition of Acute Ischemic Stroke: Imaging and Intervention provides a comprehensive account of the state of the art in the diagnosis and treatment of acute ischemic stroke. The basic format of the first edition has been retained, with sections on fundamentals such as pathophysiology and causes, imaging techniques and interventions. However, each chapter has been revised to reflect the important recent progress in advanced neuroimaging and the use of interventional tools. In addition, a new chapter is included on the classification instruments for ischemic stroke and their use in predicting outcomes and therapeutic triage. All of the authors are internationally recognized experts and members of the interdisciplinary stroke team at the Massachusetts General Hospital and Harvard Medical School. The text is supported by numerous informative illustrations, and ease of reference is ensured through the inclusion of suitable tables. This book will serve as a unique source of up-to-date information for neurologists, emergency physicians, radiologists and other health care providers who care for the patient with acute ischemic stroke.

Thrombolytic Therapy in Acute Ischemic Stroke

Thrombolytic Therapy in Acute Ischemic Stroke PDF

Author: Werner Hacke

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 355

ISBN-13: 3642764398

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During the last decade scientists in both basic and clinical research have renew ed their interest in the potential role of thrombolytic therapy in the treatment of acute ischemic stroke. The reevaluation of this approach was kindled by our growing knowledge of the pathogenesis of thrombotic and embolic stroke and by the development of new thrombolytic agents. With no proven therapy for acute ischemic stroke available, the potential value of early pharmacologic recanalization of occluded vessels in the management of acute stroke patients - an approach that has been supported by animal experiments and a limited number of uncontrolled clinical pilot studies - is again under scrutiny. A sym posium on "Thrombolysis in Acute Cerebral Ischemia" was held in Heidel berg, Germany, in May 1990 to summarize and discuss the pathophysiological background for thrombolysis in acute ischemic stroke and the recent ex perimental and clinical experience with the new generation of thrombolytic agents. The editors are fortunate to be able to include authoritative manuscripts from almost all the speakers at the symposium. These include reports of work by the most active investigators in this challenging field. The editors wish to express their gratitude to all the contributors for the additional work they have undertaken. Additionally, we would like to thank Springer-Verlag, Heidelberg, for its generous assistance in the preparation and rapid publication of this volume. Heidelberg, August 1990 WERNER HACKE GREGORY J. DEL ZopPO MATTHIAS HIRSCHBERG Contents I.

Thrombolytic Therapy in Acute Ischemic Stroke II

Thrombolytic Therapy in Acute Ischemic Stroke II PDF

Author: Gregory J. DelZoppo

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 485

ISBN-13: 364278061X

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Over the last decade, interest in treatment of ischemic stroke has increased significantly. Perhaps the single most important feature of attempts to improve the outcome of stroke patients has been that the interventions be applied within the very early hours of stroke symptoms. This has spawned efforts to understand the vascular and neuronal responses to cerebral artery reperfusion experimentally. Important prospective clinical studies of thrombolysis in acute ischemic stroke have been completed, and large placebo-controlled, symptom-based studies are now underway worldwide. Here, we consider the central features of those studies, their experimental basis, and the future importance of adjunctive therapies to recanalization in focal brain ischemia acutely. Risks and benefits are discussed. This collection benefits from the opinions of experts and workers in this rapidly evolving and exciting field.

Thrombolytic and Antithrombotic Therapy for Stroke

Thrombolytic and Antithrombotic Therapy for Stroke PDF

Author: Julian Bogousslavsky

Publisher: CRC Press

Published: 2006-07-07

Total Pages: 280

ISBN-13: 9781841842035

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Thrombolytic therapy for stroke with the introduction of tissue plasminogen activator (t-PA) was a boon to stroke physicians, since it meant that morbidity and mortality could be reduced with the optimal use of t-PA. The editor and his well-respected contributors offer the reader their personal perspectives on the evidence-based use of various thrombolytic and anti-thrombotic agents that are available and that can provide successful outcomes. Thrombolytic and Antithrombotic Therapy for Stroke is updated and thoroughly referenced. Everyone working in the casualty/emergency room must read this clearly-written text.

Thrombolytic Therapy in Acute Ischemic Stroke

Thrombolytic Therapy in Acute Ischemic Stroke PDF

Author: Werner Hacke

Publisher: Springer

Published: 1991-06-11

Total Pages: 271

ISBN-13: 9783540536802

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During the last decade scientists in both basic and clinical research have renew ed their interest in the potential role of thrombolytic therapy in the treatment of acute ischemic stroke. The reevaluation of this approach was kindled by our growing knowledge of the pathogenesis of thrombotic and embolic stroke and by the development of new thrombolytic agents. With no proven therapy for acute ischemic stroke available, the potential value of early pharmacologic recanalization of occluded vessels in the management of acute stroke patients - an approach that has been supported by animal experiments and a limited number of uncontrolled clinical pilot studies - is again under scrutiny. A sym posium on "Thrombolysis in Acute Cerebral Ischemia" was held in Heidel berg, Germany, in May 1990 to summarize and discuss the pathophysiological background for thrombolysis in acute ischemic stroke and the recent ex perimental and clinical experience with the new generation of thrombolytic agents. The editors are fortunate to be able to include authoritative manuscripts from almost all the speakers at the symposium. These include reports of work by the most active investigators in this challenging field. The editors wish to express their gratitude to all the contributors for the additional work they have undertaken. Additionally, we would like to thank Springer-Verlag, Heidelberg, for its generous assistance in the preparation and rapid publication of this volume. Heidelberg, August 1990 WERNER HACKE GREGORY J. DEL ZopPO MATTHIAS HIRSCHBERG Contents I.

Thrombolytic Therapy in Acute Ischemic Stroke III

Thrombolytic Therapy in Acute Ischemic Stroke III PDF

Author: Takenori Yamaguchi

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 358

ISBN-13: 443168459X

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On the threshold of an exciting new era for acute stroke diagnosis and treatment, the Third International Symposium on Thrombolytic Therapy in Acute Ischemic Stroke was held in Nara, Japan, in April 1994. The symposium brought together some 200 basic and clinical scientists for presentations and discussions of issues vital to the understanding of thrombolytic therapy. This volume compiles the major presentations of the symposium, with attention to applications of new diagnostic measures such as diffusion and perfusion MRI, contrast-enhanced transcranial Doppler and angioscopy. Other presentations examine the mechanisms of ischemia/reperfusion injury, hemorrhagic transformation, and reocclusion, with reviews of recent developments in thrombolytic agents. The proceedings of the symposium will be of special interest to researchers, physicians, and students in the fields of neurology, neurosurgery, and nuclear medicine, as well as those in pharmacology, critical care medicine, and related fields.

Acute Stroke Nursing

Acute Stroke Nursing PDF

Author: Jane Williams

Publisher: John Wiley & Sons

Published: 2013-05-07

Total Pages: 367

ISBN-13: 1118699629

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Stroke is a medical emergency that requires immediate medical attention. With active and efficient nursing management in the initial hours after stroke onset and throughout subsequent care, effective recovery and rehabilitation is increased. Acute Stroke Nursing provides an evidence-based, practical text facilitating the provision of optimal stroke care during the primary prevention, acute and continuing care phases. This timely and comprehensive text is structured to follow the acute stroke pathway experienced by patients. It explores the causes, symptoms and effects of stroke, and provides guidance on issues such as nutrition, continence, positioning, mobility and carer support. The text also considers rehabilitation, discharge planning, palliative care and the role of the nurse within the multi-professional team. Acute Stroke Nursing is the definitive reference on acute stroke for all nurses and healthcare professionals wishing to extend their knowledge of stroke nursing. Evidence-based and practical in style, with case studies and practice examples throughout Edited and authored by recognised stroke nursing experts, clinicians and leaders in the field of nursing practice, research and education The first text to explore stroke management from UK and international perspectives, and with a nursing focus