tenecteplase is a variant of tissue plasminogen activator (t-pa) which has better pharmacokinetic properties and more selective thrombolytic activity. in the present study, we describe a rapid method to introduce three sets of mutation into defined positions in t-pa cdna by a site-directed mutagenesis based on a megaprimer pcr approach to produce tenecteplase coding sequence where amino acids a...

BACKGROUND AND PURPOSE The purpose of this study was to determine the safety and efficacy of intravenous recombinant tissue-type plasminogen activator (0.6 mg/kg alteplase) within 3 hours of stroke onset in Japanese patients outside the indications in the European license. METHODS Of the 600 patients who were treated with recombinant tissue-type plasminogen activator, 422 met the inclusion cr...

BACKGROUND AND PURPOSE This is the first prospective evaluation of changes in systemic hematologic status following administration of intraventricular recombinant tissue-type plasminogen activator in patients with intraventricular hemorrhage (IVH). METHODS Laboratory data from subjects enrolled onto the Clot Lysis: Evaluating Accelerated Resolution of IVH (CLEAR IVH) Trials were analyzed. We ...

BACKGROUND AND PURPOSE Ultrasound has been shown to increase recombinant tissue plasminogen activator thrombolysis through stable cavitation, or sustained bubble activity, but this mechanism needs further optimization. Use of low-frequency ultrasound in combination with microbubbles stabilized against dissolution, in the form of ultrasound contrast agents, has resulted in greater lytic efficacy...

BACKGROUND AND PURPOSE We evaluated the association between recombinant tissue-type plasminogen activator recanalization and change in hemostatic markers. METHODS We studied 40 patients. Recanalization was measured with transcranial Doppler. We evaluated the change in markers of coagulation (fibrinogen) and fibrinolysis (thrombin activatable fibrinolysis inhibitor and alpha(2)-antiplasmin) in...

OBJECTIVES To assess time management of stroke thrombolysis triage and functional outcomes in patients receiving recombinant tissue plasminogen activator for hyperacute stroke, and identify bottlenecks in delivery of the treatment. DESIGN Prospective study. SETTING A university teaching hospital in Hong Kong. PATIENTS Patients with suspected hyperacute stroke referred to the stroke thromb...

Urokinase-type plasminogen activator (uPA) is synthesized as single-chain protein (scuPA) with little intrinsic activity. scuPA is activated when it is converted to two-chain urokinase (tcuPA) by plasmin or when i t binds as a single-chain molecule to -tS cellular receptor (uPAR). Previous data indicate that complexes between scuPA and its receptor have somewhat higher affmity for plasminogen t...

BACKGROUND AND PURPOSE A retrospective, multicenter, observational study was conducted to document clinical outcomes and to identify outcome predictors in patients treated with low-dose intravenous recombinant tissue plasminogen activator (0.6 mg/kg alteplase), which was approved in Japan in 2005, within 3 hours of stroke onset. METHODS Consecutive patients with stroke treated with recombinan...

BACKGROUND AND PURPOSE Acute ischemic stroke patients who receive recombinant tissue plasminogen activator (rt-PA) within 3 hours of symptom onset are 30% more likely to have minimal to no disability at 3 months. During hospitalization, short-term disability is subjectively measured by discharge disposition, whether to home, inpatient rehabilitation, a skilled nursing facility, or subacute care...

BACKGROUND AND PURPOSE Patients with renal impairment (RI) have an increased risk of both thrombotic and hemorrhagic events. We aimed to clarify whether RI increases the risk of intracerebral hemorrhage (ICH) after intravenous thrombolysis with recombinant tissue plasminogen activator. METHODS Patients who received intravenous thrombolysis with recombinant tissue plasminogen activator within ...