The combination of alteplase, a recombinant tissue plasminogen activator, and edaravone, an antioxidant, reportedly enhances recanalization after acute ischemic stroke. We examined the influence of edaravone on the thrombolytic efficacy of alteplase by measuring thrombolysis using a newly developed microchip-based flow-chamber assay. Rat models of embolic cerebral ischemia were treated with eit...

PURPOSE The efficacy and safety of i.v. alteplase up to 4.5 hours after acute ischemic stroke (AIS) onset were evaluated. SUMMARY Stroke is the leading cause of disability in the elderly, and i.v. alteplase (recombinant tissue plasminogen activator) is the only Food and Drug Administration (FDA)-approved thrombolytic agent for the treatment of AIS. Alteplase has been shown to decrease the per...

BACKGROUND AND PURPOSE Although alteplase, a recombinant tissue plasminogen activator (tPA), is structurally identical to endogenous tPA and therefore should not induce allergy, single cases of acute hypersensitivity reactions have been reported. Until now, specific antibodies against alteplase were not detected in blood samples obtained in these patients. CASE DESCRIPTION We report an anaphy...

CONTEXT Incorrect dosing of alteplase has been associated with worse clinical outcomes in patients. However, patients at high risk of adverse events are more prone to dosing errors, thus confounding this relationship. OBJECTIVE To determine if the association between incorrect dosing of alteplase and adverse outcomes is related to cause and effect or to confounding. DESIGN, SETTING, AND PAT...

Recent guidelines recommend bolus-dose alteplase for treating massive pulmonary embolism (PE). However, the safest and most effective treatment is as yet unknown. In the present study, a meta-analysis of published studies of alteplase infusion, bolus-dose alteplase and streptokinase was performed. The outcome measures were as follows: objective assessment of thrombolysis; all-cause mortality; d...

Continuous electrocardiography during the first 24 hours of a stay in a coronary care unit was used to record ventricular arrhythmias during treatment with alteplase (recombinant tissue plasminogen activator) or placebo. Recordings were made on 378 of the 436 patients admitted to a double blind trial of alteplase or placebo in one participating centre of the Anglo-Scandinavian study of early th...

BACKGROUND AND PURPOSE Because alteplase does not penetrate thrombus effectively, this study examined whether a method thought to maximize surface distribution of alteplase on the offending thrombus during IATT would result in greater reperfusion rates in acute ischemic stroke. MATERIALS AND METHODS Clinical information, arteriograms, and CT scans following treatment from 85 consecutive patie...

BACKGROUND AND PURPOSE Endovascular thrombectomy (EVT) improves the functional outcome when added to best medical therapy, including alteplase, in patients with acute ischaemic stroke secondary to large vessel occlusion (LVO) in the anterior circulation. However, the evidence for EVT in alteplase-ineligible patients is less compelling. It is also uncertain whether alteplase is necessary in pati...

BACKGROUND Intraluminal thrombosis of central venous catheters used for renal replacement therapy (RRT) decreases the ability to provide adequate treatment. Alteplase is a recombinant tissue plasminogen activator that has been used to improve the function of catheters used for RRT in humans. OBJECTIVES To retrospectively review alteplase instillation in dysfunctional catheters used for RRT in...