T he primary goal of thrombolytic therapy in acute myocardial infarction (AMI) is the early restoration of perfusion and maintenance of viability and function of myocardium that would otherwise undergo necrosis consequent to thrombotic coronary artery occlusion. The salvage achieved by thrombolysis ranges from a minute amount of myocardium of little functional significance to a large mass of he...

BACKGROUND Although thrombolytic therapy has shown substantial benefits in neural outcomes, concerns remain regarding the association between thrombolytic therapy and possible increased mortality. OBJECTIVE To determine the mortality risk of certain thrombolytic agents that are a treatment option for acute ischemic stroke. DATA SOURCES, EXTRACTION, AND SYNTHESIS Studies were identified usin...

It has been observed that ticlopidine and clopidogrel show, apart from their delayed antiplatelet properties, an immediate and transient thrombolytic action related to the ability of these thienopyridines to stimulate the secretory function of vascular endothelium. With the objective to construct new molecules with identical thrombolytic potency but at a higher level, we carried out different s...

BACKGROUND AND PURPOSE This study evaluated the safety and efficacy of aggressive mechanical clot disruption (AMCD) in acute stroke patients with persisting middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion after thrombolytic therapy. METHODS Retrospective case series were used from a prospectively collected stroke database on consecutive acute ischemic stroke patients t...

OBJECTIVE To report our experience with low-dose tissue plasminogen activator in the treatment of calciphylaxis, a rare, usually fatal thrombotic condition that results in ischemia, necrosis, and infarction of adipose and cutaneous tissue. DESIGN Retrospective chart review. SETTING Tertiary care academic medical center. PATIENTS Fifteen patients (4 men and 11 women) with calciphylaxis, tr...

INTRODUCTION Porcine thrombi are employed routinely in preclinical models of ischemic stroke. In this study, we examined the differential lytic susceptibility of porcine and human whole blood clots with and without the use of microbubbles and ultrasound (US) as an adjuvant. MATERIALS AND METHODS An in vitro system equipped with time-lapse microscopy was used to evaluate recombinant tissue-pla...

Reperfusion therapy has been clearly shown to decrease the early mortality after acute myocardial infarction, but the impact of this therapy on long-term survival has been less extensively evaluated. This study reports the extended follow-up of a large cohort of 810 patients treated with intravenous thrombolytic therapy combined, when considered necessary to maintain or augment infarct vessel p...

OBJECTIVES To compare a system of prehospital thrombolytic therapy, delivered by paramedics under medical guidance, with in-hospital thrombolytic therapy in meeting National Service Framework (NSF) targets for treatment of acute myocardial infarction at a District General Hospital setting in England. DESIGN Retrospective observational case-control study comparing patients with suspected acute...

AIM Thrombolytic therapy induces faster clot dissolution than anticoagulation in patients with acute pulmonary embolism (PE) but is associated with an increased risk of haemorrhage. We reviewed the risks and benefits of thrombolytic therapy in the management of patients with acute PE. METHODS AND RESULTS We systematically reviewed randomized controlled studies comparing systemic thrombolytic ...

BACKGROUND The efficacy of thrombolytic therapy for acute ischemic stroke remains controversial in emergency medicine and has not been fully endorsed by either the American College of Emergency Physicians or the American Academy of emergency medicine. A growing recognition exists of the influence of pharmaceutical sponsorship on the reported findings of published clinical trials. Sponsorship bi...