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intravenous tirofiban therapy for patients with capsular warning syndrome

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Stroke & Vascular Neurology 2019年第1期4卷 22-27页

作者： Wei Li Ya Wu Xiao-Shu Li Cheng-Chun Liu Shu-Han Huang Chun-Rong Liang Huan Wang Li-Li Zhang Zhi-Qiang Xu Yan-Jiang Wang Meng Zhang Department of Neurology Daping Hospital&Research Institute of SurgeryThe Army Military Medical UniversityChongqingChina

Background Capsular warning syndrome(CWS)is defined as recurrent episodes of transient ischaemic attacks≥3 times during a short time *** is no effective therapy to stop these ***,herein,report our experience of using intravenous tirofiban to treat *** All patients with CWS in our hospital from January 2013 to September 2017 were *** in tirofiban group(T-group)were treated by intravenous tirofiban at 0.4μg/kg/min for 30 min followed by 0.1-0.15μg/kg/min *** treatments(non-T-group)included thrombolytic,oral antiplatelet agents and *** haemorrhage(ICH),systematic bleeding,new attacks after treatment,National Institutes of Health Stroke Scale(NIHSS)scores at 24 hours and modified Rankin Scales(mRSs)at 3 months were *** statistics were used for *** Of 23 patients qualified(15 in T-group,8 in non-T-group),the duration of symptoms ranged from 2 to 100 min before *** treatment,in T-group,four patients(26.7%)had recurrent attacks,and NIHSS scores were 0 in 11 patients(73.3%)at 24 *** patients reached a favourable outcome(mRS≤2) at 3 *** non-T-group,five patients(62.5%)had new *** scores were 0 in two patients(25%)at 24 *** 3 months,seven patients(87.5%)reached a favourable *** ICH nor systematic bleeding or thrombocytopaenia occurred in both groups of *** intravenous tirofiban can be a potentially effective and safe therapy to stop early symptomatic fluctuations and shorten the duration of functional deficits in patients with CWS.

关键词： patients intravenous intravenous

Association between fluid-attenuated inversion recovery vascular hyperintensity and outcome varies with different lesion patterns in patients with intravenous thrombolysis

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Stroke & Vascular Neurology 2021年第3期6卷 449-457,I0076页

作者： Erling Wang Chuanjie Wu Dandan Yang Xihai Zhao Jie Zhao Hong Chang Qi Yang Department of Radiology Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Department of Neurology Xuanwu HospitalCapital Medical UniversityBeijingChina Beijing Institute of Brain Disorders Laboratory of Brain DisordersMinistry of Science and TechnologyCollaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina Center for Biomedical Imaging Research Department of Biomedical EngineeringTsinghua UniversityBeijingChina Key Laboratory of Medical Engineering for Cardiovascular Disease Ministry of EducationBeijingChina

Background and purpose To evaluate relationship between fluid-attenuated inversion recovery vascular hyperintensity(FVH)after intravenous thrombolysis and outcomes in different lesion patterns on diffusion-weighted imaging(DWI).Methods Patients with severe internal carotid or intracranial artery stenosis who received intravenous thrombolysis from March 2012 to April 2019 were *** were divided into four groups by DWI lesion patterns:border-zone infarct(BZ group),multiple lesions infarct(ML group),large territory infarct(LT group),and single cortical or subcortical lesion infarct(SL group).Logistic regression was performed to identify risk factors for outcome(unfavourable outcome,modified Rankin Scale(mRS)≥2;poor outcome,mRS≥3).Results Finally,203 participants(63.3±10.2 years old;BZ group,n=72;ML group,n=64;LT group,n=37;SL group,n=30)from 1190 patient cohorts were *** adjusting for confounding factors,FVH(+)was associated with unfavourable outcome in total group(OR 3.02;95%CI 1.49 to 6.13;p=0.002),BZ group(OR 4.22;95%CI 1.25 to 14.25;p=0.021)and ML group(OR 5.44;95%CI 1.41 to 20.92;p=0.014)***(+)was associated with poor outcome in total group(OR 2.25;95%CI 1.01 to 4.97;p=0.046),BZ group(OR 5.52;95%CI 0.98 to 31.07;p=0.053)and ML group(OR 4.09;95%CI 1.04 to 16.16;p=0.045)patients,which was marginal ***(+)was not associated with unfavourable or poor outcome in LT and SL *** This study suggests that association between FVH and outcome varies with different lesion patterns on *** presence of FVH after intravenous thrombolysis may help to identify patients who require close observations in the hospitalisation in patients with border-zone and multiple lesion infarcts.

关键词： patients thrombolysis intravenous

Is intraprocedural intravenous aspirin safe for patients who require emergent extracranial stenting during mechanical thrombectomy?

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Stroke & Vascular Neurology 2024年第3期9卷 279-288,I0247页

作者： Adam Ingleton Marko Raseta Rui-En Chung Kevin Jun Hui Kow Jake Weddell Sanjeev Nayak Changez Jadun Zafar Hashim Noman Qayyum Phillip Ferdinand Indira Natarajan Christine Roffe Neurosciences University Hospitals of North Midlands NHS TrustStoke-on TrentUK Statistics and Mathematical Modelling Department of Molecular GeneticsErasmus Medical CenterRotterdamZuid-HollandThe Netherlands Radiology University Hospitals of North Midlands NHS TrustStoke-on TrentUK School of Medicine Keele UniversityKeeleUK Interventional Radiology University Hospitals of North Midlands NHS TrustStoke-on TrentUK Stroke Research Keele UniversityKeeleUK

Background Intraoperative antiplatelet therapy is recommended for emergent stenting during mechanical thrombectomy(MT).Most patients undergoing MT are also given *** agents are contraindicated within 24 hours of *** evaluated outcomes and complications of patients stented with and without intravenous aspirin during *** All patients who underwent emergent extracranial stenting during MT at the Royal Stoke University Hospital,UK between 2010 and 2020,were *** were thrombolysed before MT,unless *** 500 mg intravenously was given intraoperatively at the discretion of the *** intracranial haemorrhage(sICH)and the National Institutes for Health Stroke Scale score(NIHSS)were recorded at 7 days,and mortality and functional recovery(modified Rankin Scale:mRS≤2)at 90 *** Out of 565 patients treated by MT 102 patients(median age 67 IQR 57–72 years,baseline median NIHSS 18 IQR 13–23,76(75%)thrombolysed)had a stent *** these 49(48%)were given aspirin and 53(52%)were *** treated with aspirin had greater NIHSS improvement(median 8 IQR 1–16 vs median 3 IQR-9–8 points,p=0.003),but there were no significant differences in sICH(2/49(4%)vs 9/53(17%)),mRS≤2(25/49(51%)vs 19/53(36%))and mortality(10/49(20%)vs 12/53(23%))with and without *** improvement(median 12 IQR 4–18 vs median 7 IQR-7–10,p=0.01)was greater,and mortality was lower(4/33(12%)vs 6/15(40%),p=0.05)when aspirin was combined with thrombolysis,than for aspirin alone,with no increase in *** Our findings based on registry data derived from routine clinical care suggest that intraprocedural intravenous aspirin in patients undergoing emergent stenting during MT does not increase sICH and is associated with good clinical outcomes,even when combined with intravenous thrombolysis.

关键词： patients aspirin intravenous

In vivo theranostics with near-infraredemitting carbon dots—highly efficient photothermal therapy based on passive targeting after intravenous administration

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Light(Science & Applications) 2018年第1期7卷 182-192页

作者： Xin Bao Ye Yuan Jingqin Chen Bohan Zhang Di Li Ding Zhou Pengtao Jing Guiying Xu Yingli Wang Kateřina Holá Dezhen Shen Changfeng Wu Liang Song Chengbo Liu Radek Zbořil Songnan Qu State Key Laboratory of Luminescence and Applications Changchun Institute of Optics Fine Mechanics and Physics Chinese Academy of Sciences3888 Dong Nanhu RoadChangchun 130033China School of Physical Sciences University of Chinese Academy of SciencesBeijing 100190China Department of Biomedical Engineering Southern University of Science and EngineeringShenzhenGuangdong 518055China Research Laboratory for Biomedical Optics and Molecular Imaging Institute of Biomedical and Health EngineeringShenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen 518055China Jilin Provincial Tumor Hospital ChangchunChina Department of Physical Chemistry Faculty of ScienceRegional Centre of Advanced Technologies and MaterialsPalackýUniversity Olomouc78371 OlomoucCzech Republic CAS Key Laboratory of Health Informatics Shenzhen Institutes of Advanced TechnologyShenzhen 518055China.

Carbon dots that exhibit near-infrared fluorescence(NIR CDs)are considered emerging nanomaterials for advanced biomedical applications with low toxicity and superior photostability and targeting compared to currently used photoluminescence *** progress in the synthesis of NIR CDs,there remains a key obstacle to using them as an in vivo theranostic *** work demonstrates that the newly developed sulfur and nitrogen codoped NIR CDs are highly efficient in photothermal therapy(PTT)in mouse models(conversion efficiency of 59%)and can be readily visualized by photoluminescence and photoacoustic *** real theranostic potential of NIR CDs is enhanced by their unique biodistribution and *** to all other nanomaterials that have been tested in biomedicine,they are excreted through the body’s renal filtration ***,after intravenous injection,NIR CDs are accumulated in tumor tissue via passive targeting,without any active species such as *** to their accumulation in tumor tissue without the need for intratumor injection,high photothermal conversion,excellent optical and photoacoustic imaging performance,and renal excretion,the developed CDs are suitable for transfer to clinical biomedical practice.

关键词： intravenous injection vivo

Treatment with intravenous alteplase in ischaemic stroke patients with onset time between 4.5 and 24 hours(HOPE):protocol for a randomised,controlled,multicentre study

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Stroke & Vascular Neurology 2024年第3期9卷 318-323,I0274-I0282页

作者： Zhongyu Luo Ying Zhou Yaode He Shenqiang Yan Zhicai Chen Xuting Zhang Yi Chen Lu-Sha Tong Wansi Zhong Haitao Hu Kemeng Zhang Jiansheng Yang Bruce C V Campbell Min Lou Department of Neurology Zhejiang University School of Medicine Second Affiliated HospitalHangzhouZhejiangChina Department of Medicine and Neurology Melbourne Brain Centre at Royal Melbourne HospitalParkvilleVictoriaAustralia

Background While intravenous thrombolysis is recommended for patients who had an acute ischaemic stroke(AIS)within 4.5hours of symptom onset,there are few randomised trials investigating the benefits of thrombolysis beyond this therapeutic *** To determine whether patients who had an AIS selected with the presence of potentially salvageable tissue on CT perfusion at 4.5–24hours after stroke onset(for stroke with unknown onset time,the midpoint of the time last known to be well and symptom recognition time;for wake-up stroke,the midpoint of the time last known to be well or sleep onset and wake up time)will benefit from intravenous *** HOPE is a prospective,multicentre,randomised,open-label blinded endpoint trial with the stage of phase *** treatment allocation employs 1:1 *** treatment arm under investigation is alteplase with standard therapy,the control arm is standard *** imaging criteria include ischaemic core volume≤70mL,penumbra≥10mL and mismatch≥20%.Study outcomes The primary outcome is non-disabled functional outcome(assessed as modified Rankin Scale score of 0–1 at 90 days).Discussion HOPE is the first trial to investigate whether intravenous thrombolysis with alteplase offers benefits in patients who had an AIS presenting within 4.5–24hours,which has the potential to extend time window and expand eligible population for thrombolysis therapy.

关键词： patients intravenous centre

Biomarkers of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease

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World Journal of Pediatrics 2019年第2期15卷 168-175页

作者： Wei-Xing Kong Fei-Yue Ma Song-Ling Fu Wei Wang Chun-Hong Xie Yi-Ying Zhang Fang-Qi Gong Department of Cardiovascular Diseases Children's HospitalZhejiang University School of Medicine3333 Binsheng RoadHangzhou 310052China

Background Currently,there are no reliable indicators for predicting intravenous immunoglobulin resistance and coronary artery lesions in the early stage of Kawasaki *** A total of 300 patients with Kawasaki disease were studied *** data were compared between the intravenous immunoglobulin resistant (29 patients) and responsive groups,and between the groups with coronary artery lesions (48 patients) and without coronary artery *** The intravenous immunoglobulin resistant group had significantly higher D-dimer,globulin,interleukin-6 and serum ferritin levels in comparison to the intravenous immunoglobulin responder group.D-dimer level had a sensitivity of 87.0% and a specificity of 56.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 1.09 mg/*** had a sensitivity of 62.1% and a specificity of 82.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 34.7 g/*** ferritin level had a sensitivity of 42.9% and a specificity of 88.8% for predicting intravenous immunoglobulin resistance at a cutoff point of 269.7 ng/*** patients with coronary artery lesions had higher D-dimer and tumor necrosis factor-α level.D-dimer level had a sensitivity of 50% and a specificity of 78.6% for predicting coronary artery lesions at a cutoff point of 1.84 mg/*** on analysis by multivariate logistic regression,serum ferritin and globulin were independent risks for intravenous immunoglobulin resistance,D-dimer was independent risk for coronary artery *** Elevated serum ferritin,globulin and D-dimer levels are significantly associated with intravenous immunoglobulin resistance in Kawasaki ***,serum D-dimer is significantly increased in Kawasaki disease with coronary artery lesions.

关键词： Biomarkers Coronary artery lesions intravenous immunoglobulin resistance Kawasaki disease

Mobile stroke care expedites intravenous thrombolysis and endovascular thrombectomy

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Stroke & Vascular Neurology 2022年第3期7卷 209-214页

作者： Matthew T Bender Thomas K Mattingly Redi Rahmani Diana Proper Walter A Burnett Jason L Burgett Joshua LEsperance Jeremy T Cushman Webster H Pilcher Curtis G Benesch Adam G Kelly Tarun Bhalla Department of Neurosurgery University of Rochester Medical CenterRochesterNew YorkUSA Department of Emergency Medicine University of Rochester Medical CenterRochesterNew YorkUSA Department of Neurology University of Rochester Medical CenterRochesterNew YorkUSA

Background The number of mobile stroke programmes has increased with evidence,showing they expedite intravenous *** questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical *** Our mobile stroke unit(MSU),based at an academic medical centre in upstate New York,launched in October *** reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service(EMS)patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical *** Over 568 days in service,the MSU was dispatched 1489 times(2.6/day)and transported 300 patients(20%of dispatches).intravenous tissue plasminogen activator(tPA)was administered to 57 MSU patients and the average time from 911 call-to tPA was 42.5 min(±9.2),while EMS transported 73 patients who received tPA at 99.4 min(±35.7)(pintravenous thrombolysis or endovascular thrombectomy,whether assessed as a dichotomous or ordinal *** Mobile stroke care expedited both intravenous thrombolysis and endovascular *** is an ongoing need to show improved functional outcomes with MSU care.

关键词： intravenous throm endovascular

Endovascular treatment with or without intravenous alteplase for acute ischaemic stroke due to basilar artery occlusion

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Stroke & Vascular Neurology 2022年第3期7卷 190-199页

作者： Ximing Nie David Wang Yuehua Pu Yufei Wei Qixuan Lu Hongyi Yan Xin Liu Lina Zheng Jingyi Liu Xinxuan Yang Yarong Ding Dacheng Liu Wanying Duan Zhe Zhang Zhonghua Yang Miao Wen Weibin Gu Xinyi Hou Xinyi Leng Yuesong Pan Zhongrong Miao Liping Liu Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Neurovascular Division Department of NeurologyBarrow Neurological InstitutePhoenixArizonaUSA Department of Medicine and Therapeutics Prince of Wales HospitalHong KongChina Department of Radiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Interventional Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina

Background and purpose It remains controversial if endovascular treatment(EVT)can improve the outcome of patients with acute basilar artery occlusion(BAO).This study aims to compare the functional outcomes between EVT with and without intravenous thrombolysis(IVT)first in patients who had acute ischaemic stroke(AIS)due to *** Patients who had AIS with BAO who underwent EVT within 24 hours of onset were enrolled in this multicentre cohort study,and the efficacy and safety were compared between IVT+EVT and direct *** primary outcome was 90-day functional *** outcomes were assessed with adjusted OR(aOR)from the multivariable logistic *** addition,a meta-analysis was performed on all recently published pivotal studies on functional independence after EVT in patients with *** Of 310 enrolled patients with BAO,241(78%)were treated with direct EVT and 69(22%)with IVT+*** EVT was associated with a worse functional outcome(aOR,0.46(95%CI 0.24 to 0.85),p=0.01).IVT+EVT was associated with a lower percentage of patients who needed≥3 passes of stent retriever(10.14%vs 20.75%).The meta-analysis regression revealed a potential positive correlation between bridging with IVT first and functional independence(r=0.14(95%CI 0.05 to 0.24),p<0.01).Conclusions This study showed that compared with direct EVT,EVT with IVT first was associated with better functional outcomes in patients with BAO treated within 24 hours of *** meta-analysis demonstrated similar favourable efficacy of IVT first followed by EVT in patients with BAO.

关键词： acute intravenous occlusion

GRP per capita and hospital characteristics associated with intravenous tissue plasminogen activator adherence rate:evidence from the Chinese Stroke Center Alliance

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Stroke & Vascular Neurology 2021年第3期6卷 337-343,I0001-I0005页

作者： Suxi Zheng Tian Jie Lyu Zixiao Li Hongqiu Gu Xin Yang Chunjuan Wang Hao Li Yong Jiang Haipeng Shen Yongjun Wang Innvotion and Information Management HKU Business SchoolThe University of Hong KongHong KongChina China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina National Center for Healthcare Quality Management in Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Chinese Institute for Brain Research BeijingChina Shenzhen Institute of Research and Innovation The University of Hong KongShenzhenChina

Background Timely delivery of intravenous tissue plasminogen activator(IV-rt PA)is pivotal to eligible patients who had a stroke while achieving higher rates of IV-rt PA has been *** paper focuses on investigating influential factors associated with the administration of IV-rt PA,primarily per capita gross regional product(GRP)and healthcare system *** The study included 980 hospitals in the Chinese Stroke Center Alliance where 158003 patients who had an acute ischaemic stroke received IV-rt PA between August 2015 and August *** adherence rate to IV-rt PA within 4.5 hours time window in each hospital was the primary *** factors were grouped into two categories:macroeconomic status and hospital *** outcome was analysed using multivariable linear *** GRP per capita(β=2.37,p<0.001),hospital stroke centre certification(β=3.77,p<0.001),number of neurologists(β=0.12,p<0.001),existence of emergency services for neurological treatment(β=7.43,p=0.014),presence of emergency department(β=10.03,p=0.019)and cooperating with emergency centre(β=4.65,p=0.029)were significantly positively associated with the adherence rate to IV-rt *** Higher GRP per capita,affluent neurological personnel,well-equipped emergency services for neurological treatment and routine cooperation with the emergency centre were important for enhancing the adherence rate to IV-rt PA among patients who had an acute ischaemic stroke in China.

关键词： intravenous routine Alliance