BACKGROUND AND PURPOSE There are few in vivo data on the pathophysiology of reperfusion during systemic thrombolysis. We monitored the time course of cerebral perfusion changes in patients during thrombolysis with repeated arterial spin labeling perfusion magnetic resonance imaging. METHODS Ten patients with proximal arterial occlusion within 4.5 hours after symptom onset were prospectively e...

OBJECTIVE To improve the thrombolysis service offered by Gloucester Royal Hospital, by reducing the "door to needle time" (DTN) to 30 min (from a median of 110 min), and increasing the proportion of patients with acute myocardial infarctions receiving thrombolysis to 70% (from 58%). This would be achieved by moving the thrombolysis programme from the coronary care unit (CCU) to the accident and...

This is an extensive review of thrombolysis in myocardial infarction with discussions of the pathophysiology of occlusion, clinical occlusion and rationale for thrombolysis, thrombolytic agents, results of thrombolysis (incidence of reperfusion, left ventricular function, and mortality), complications of thrombolytic therapy, reocclusion, and current recommendations.

The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require sur...

BACKGROUND Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS A retrospective observational study of patients who received intravenous throm...

OBJECTIVE To assess the clinical impact of on-site thrombolysis versus referral to another hospital in patients with ischemic stroke attended in a hospital lacking a stroke unit. DESIGN Expected value decision analysis and Monte Carlo simulation. PATIENTS AND SETTING Decision analysis based on a cohort study (SIT-MOST) and a meta-analysis of randomized trials of thrombolysis versus placebo ...

BACKGROUND AND PURPOSE Widespread use of thrombolytic treatments, along with improved chances of survival after an initial ischemic stroke, increases the possibility of repeated thrombolysis. There are few reports, however, regarding repeated thrombolysis in patients who have suffered acute ischemic stroke. We explored the number and outcome of patients with repeated thrombolytic therapy in the...