Linked Life Data

3142317

Source:http://linkedlifedata.com/resource/pubmed/id/3142317

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
1988-12-12
pubmed:abstractText
Significant current interest has focused on the possible value of fibrin-selective thrombolytic agents in acute stroke. Acute thrombosis contributes to carotid and vertebrobasilar arterial occlusions in the majority of acute stroke patients. Hence, fibrin(ogen)olytic agents may produce arterial recanalization and clinical benefit in thrombotic stroke. There are, however, unique features of cerebral tissue that suggest caution with the use of fibrin-selective agents in cerebral ischemia. The specific vascular anatomy and collateral flow suggest that salvage of the "ischemic penumbra" following vascular recanalization in focal ischemia is more likely to be successful than attempts in global ischemia. Recanalization may be associated with reperfusion injury and, more importantly, the risk of hemorrhagic transformation. There is little concrete information regarding the relative contribution of either event to post-thrombolysis cerebral injury. Early studies with exogenous fibrinolytic agents (urokinase, streptokinase) in completed stroke were regarded as inconclusive, demonstrating only an increased risk of intracerebral hemorrhage. Subsequent pilot studies in carotid and in vertebrobasilar territory thrombotic stroke have demonstrated that recanalization can result when exogenous agents are infused just proximal to the cerebral artery occlusion by interventional neuroradiological techniques. This experience and the advent of fibrin-selective agents (tissue plasminogen activator [tPA] and single-chain urokinase plasminogen activator) have led to the development of a multicenter prospective safety/dose-ranging study of tPA in acute (less than eight hours from symptom onset) thrombotic stroke. Following initial clinical assessment, computed tomography scan, and angiography, each patient with a documented cerebral artery occlusion appropriate to the clinical syndrome receives a preassigned intravenous dose of tPA over 60 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0196-0644
pubmed:author
pubmed:issnType
Print
pubmed:volume
17
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1196-201
pubmed:dateRevised
2007-11-14
pubmed:meshHeading
pubmed:year
1988
pubmed:articleTitle
Investigational use of tPA in acute stroke.
pubmed:affiliation
Department of Basic and Clinical Research, Research Institute of Scripps Clinic, La Jolla, California 92037.
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, P.H.S., Review