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Ultraearly repeated systemic thrombolysis in recurrent ischemic stroke - A multicentre case study
T. Etgen, M. Cappellari, D. Černík, R. Topakian, LA. Sposato, P. Sardag, H. Wiestler
Language English Country Netherlands
Document type Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Cerebral Hemorrhage etiology MeSH
- Stroke * diagnostic imaging drug therapy MeSH
- Fibrinolytic Agents therapeutic use MeSH
- Ischemic Stroke * drug therapy MeSH
- Brain Ischemia * diagnostic imaging drug therapy MeSH
- Humans MeSH
- Prospective Studies MeSH
- Tissue Plasminogen Activator therapeutic use MeSH
- Thrombolytic Therapy methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: We analysed outcomes of patients who received off-label repeated thrombolysis with recombinant tissue plasminogen activator for ischemic stroke recurrence within 10 days (ultraearly repeated thrombolysis, UERT). METHOD: We identified patients receiving UERT from the prospective telestroke network of South-East Bavaria (TEMPiS) registry and by database search (Pubmed, Google scholar). Corresponding authors were contacted for further details. Baseline demographic data and clinical, laboratory, and imaging findings were analysed in a multicentric case study. RESULTS: Sixteen patients receiving UERT were identified. The median time between first and second thrombolysis was 3.5 days. In patients with available data, second thrombolysis achieved an early clinical improvement (NIHSS reduction ≥4 points) in 12 of 14 (85.7%) and a favourable outcome (mRS 0-2 after 3 months) in 11 of 16 (68.8%) patients. Intracerebral haemorrhage (ICH) occurred in 4 patients (25.0%) with one fatal large parenchymatous haemorrhage (6.3%). Neither allergic reactions nor other immunoreactive events were observed. CONCLUSIONS: In our analysis UERT led to early clinical improvement and a favourable clinical outcome in a high percentage of patients with ICH rates comparable to prior publications. UERT might be considered in patients with early recurrent stroke under careful risk-benefit assessment.
Department of Neurology Academic Teaching Hospital Wels Grieskirchen Wels Austria
Helios Klinikum München West Klinik für Neurologie und Neurogeriatrie München Germany
Klinik für Neurologie Klinikum Traunstein Germany
Klinik und Poliklinik für Psychiatrie und Psychotherapie Technische Universität München Germany
Stroke Unit Azienda Ospedaliera Universitaria Integrata Verona Italy
References provided by Crossref.org
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- $a Etgen, Thorleif $u Klinik für Neurologie, Klinikum Traunstein, Germany; Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany. Electronic address: thorleif.etgen@kliniken-sob.de
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- $a Ultraearly repeated systemic thrombolysis in recurrent ischemic stroke - A multicentre case study / $c T. Etgen, M. Cappellari, D. Černík, R. Topakian, LA. Sposato, P. Sardag, H. Wiestler
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- $a OBJECTIVE: We analysed outcomes of patients who received off-label repeated thrombolysis with recombinant tissue plasminogen activator for ischemic stroke recurrence within 10 days (ultraearly repeated thrombolysis, UERT). METHOD: We identified patients receiving UERT from the prospective telestroke network of South-East Bavaria (TEMPiS) registry and by database search (Pubmed, Google scholar). Corresponding authors were contacted for further details. Baseline demographic data and clinical, laboratory, and imaging findings were analysed in a multicentric case study. RESULTS: Sixteen patients receiving UERT were identified. The median time between first and second thrombolysis was 3.5 days. In patients with available data, second thrombolysis achieved an early clinical improvement (NIHSS reduction ≥4 points) in 12 of 14 (85.7%) and a favourable outcome (mRS 0-2 after 3 months) in 11 of 16 (68.8%) patients. Intracerebral haemorrhage (ICH) occurred in 4 patients (25.0%) with one fatal large parenchymatous haemorrhage (6.3%). Neither allergic reactions nor other immunoreactive events were observed. CONCLUSIONS: In our analysis UERT led to early clinical improvement and a favourable clinical outcome in a high percentage of patients with ICH rates comparable to prior publications. UERT might be considered in patients with early recurrent stroke under careful risk-benefit assessment.
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