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Beyond Intravenous Thrombolysis

Published online by Cambridge University Press:  07 November 2014

Kiwon Lee ,
Srikanth Muppidi ,
Farhan Siddiq ,
Carissa Pineda ,
David G. Brock  and
Rodney D. Bell
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Abstract

The National Institute of Neurological Disorders and Stroke trial of recombinant tissue plasminogen activator has been considered a landmark study in the acute treatment of ischemic stroke. Unfortunately, only a small percentage of all ischemic stroke patients presents to the hospital in time to receive the drug. Moreover, the recannalization rate of a major artery occlusion, such as the proximal middle cerebral artery or top of the internal carotid artery occlusion, after intravenous (IV) thrombolytic therapy has been disappointingly low. Since the Food and Drug Administration's approval of IV plasminogen activator, there have been numerous randomized clinical trials investigating the safety and efficacy of different thrombolytics administered in various time frames. In addition to the IV administration, efforts have been made in order to study the radiographic as well as clinical effects of intra-arterial (IA) thrombolysis. The combination of IV and IA thrombolysis has been studied. For patients who do not qualify for receiving chemical thrombolysis, new devices have been developed for mechanical thrombectomy.

Type
Review Articles
Information
CNS Spectrums , Volume 12 , Issue 8 , August 2007 , pp. 609 - 614
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

1.National Institute of Neurological Disorders and Stroke rt-pa stroke study group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–1587.CrossRefGoogle Scholar
2.ECASS investigators. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA. 1995;274:1017–1025.CrossRefGoogle Scholar
3.Second European-Australasian Acute Stroke Study Investigators. Randomized double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplace in acute ischemic stroke (ECASS II). Lancet. 1998;352:1245–1251.CrossRefGoogle Scholar
4.Clark, WM, Albers, GW, Madden, KP, Hamilton, S. The rtPA (alteplase) 0- to 6-hour acute stroke trial, part A (A0276g): results of a double-blind, placebo-controlled, multicenter study. Thromblytic therapy in acute ischemic stroke study investigators. Stroke. 2000;31:811–816.CrossRefGoogle Scholar
5.Clark, WM, Wissman, S, Albers, GW, Jhamandas, JH, Madden, KP, Hamilton, S. Recombinant tissue-type plasminogen activator (Alteplase) for ischemic stroke 3 to 5 hours after symptom onset. The ATLANTIS Study: a randomized controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in ischemic Stroke. JAMA. 1999;282:2019–2026.CrossRefGoogle ScholarPubMed
6.The Atlantis, ECASS, and NINDS rt-PA Study Group Investigators. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363:768–774.CrossRefGoogle Scholar
7.Hacke, W, Albers, G, Al-Rawi, Y, et al.The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke. 2005;36:66–73.CrossRefGoogle Scholar
8.Barbash, GI, Roth, A, Hod, H, et al.Randomized controlled trial of late in-hospital angiography and angioplasty versus conservative management after treatment with recombinant tissue-type plasminogen activator in acute myocardial infarction. Am J Cardiol. 1990;66:538–545.CrossRefGoogle ScholarPubMed
9.del Zoppo, GJ, Higashida, RT, Furlan, AJ, Pessin, MS, Rowley, HA, Gent, M. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism. Stroke. 1998;29:4–11.CrossRefGoogle ScholarPubMed
10.Furlan, A, Higashida, R, Wechsler, L, et al.Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA. 1999;282:2003–2011.CrossRefGoogle ScholarPubMed
11.Lewandowski, CA, Frankel, M, Tomsick, TA, et al.Combined intravenous and intraarterial r-TPA versus intra-arterial therapy of acute ischemic stroke: Emergency Management of Stroke (EMS) Bridging Trial. Stroke. 1999;30:2598–2605.CrossRefGoogle ScholarPubMed
12.IMS Study Investigators. Combined intravenous and intra-arterial recanalization for acute ischemic stroke: the Interventional Management of Stroke Study. Stroke. 2004;35:904–911.CrossRefGoogle Scholar
13.Megan, LC, Saver, JL, Gobin, YP, et al.Beyond tissue plasminogen activator: mechanical intervention in acute stroke. Ann Emerg Med. 2003;41:838–845.Google Scholar
14.Concentric Medical. Product Summary Information for the Concentric Retriever System. Mountain View, Calif: Concentric Medical; 2001:1–7.Google Scholar
15.Williams, DO, Borer, J, Braunwald, E, et al.Intravenous recombinant tissue-type plasminogen activator in patients with acute myocardial infarction: a report from the NHLBI thrombolysis in myocardial infarction trial. Circulation. 1986;73:338–346.CrossRefGoogle ScholarPubMed
16.Smith, WS, Sung, G, Starman, S, et al.Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke. 2005;36:1432–1438.CrossRefGoogle ScholarPubMed
17.IMS Study Investigators. Combined intravenous and intra-arterial recanalization for acute ischemic stroke: the Interventional Management of Stroke Study. Stroke. 2004;35:904–911.CrossRefGoogle Scholar
18.Smith, WS. Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I. AJNR Am J Neuroradiol. 2006;27:1177–1182.Google ScholarPubMed
19.Spengos, K, Behrens, S, Daffertshofer, M, Dempfle, CE, Hennerici, M. Acceleration of thrombolysis with ultrasound through the cranium in a flow model. Ultrasound Med Biol. 2000;26:889–895.CrossRefGoogle Scholar
20.Sehgal, CM, Leveen, RF, Shlansky-Goldberg, RD. Ultrasound-assisted thrombolysis. Invest Radiol. 1993;28:939–943.CrossRefGoogle ScholarPubMed
21.Francis, CW. Ultrasound-enhanced thrombolysis. Echocardiography. 2001;18:239–246.CrossRefGoogle ScholarPubMed
22.Francis, CW, Blinc, A, Lee, S, Cox, C. Ultrasound accelerated transport of recombinant tissue plaminogen activator into clots. Ultrasound Med Biol. 1995;21:419–424.CrossRefGoogle Scholar
23.Blinc, A, Kennedy, SD, Bryant, RG, Marder, VJ, Francis, CW. Flow through clots determines the rate and pattern of fibrinolysis. Thromb Haemost. 1994;71:230–235.Google ScholarPubMed
24.Trubestein, R, Engel, C, Etzel, F, et al.Thrombolysis by ultrasound. Clin Sci Mol Med Suppl. 1976;3:697s–698s.Google ScholarPubMed
25.Alexandrov, AV, Demchuk, AM, Felberg, RA, et al.High rate of complete recanalization and dramatic clinical recovery during tPA infusion when continuously monitored with 2-MHz transcranial doppler monitoring. Stroke. 2000;31:610–614CrossRefGoogle ScholarPubMed
26.Alexandrov, AV, Molina, CA, Grotta, JC, et al.Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med. 2004;351:2170–2178.CrossRefGoogle ScholarPubMed
27.Demchuk, AM, Burgin, WS, Christou, I, et al.Thrombolysis in brain ischemia (TIBI) transcranial Doppler flow grades predict clinical severity, early recovery, and mortality in patients treated with intravenous tissue plasminogen activator. Stroke. 2001;32:89–93.CrossRefGoogle ScholarPubMed
28.Demchuk, AM, Christou, I, Wein, TH, et al.Accuracy and criteria for localizing arterial occlusion with transcranial Doppler. J Neuroimaging. 2000;10:1–12.CrossRefGoogle ScholarPubMed
29.Burgin, WE, Malkoff, M, Felberg, RA, et al.Transcranial doppler ultrasound criteria for recanalization after thrombolysis for middle cerebral artery stroke. Stroke. 2000;31:1128–1132.CrossRefGoogle ScholarPubMed
30.Vesely, TM, William, D, Weiss, M, et al.Comparison of the angiojet rheolytic catheter to surgical thrombectomy for the treatment of thrombosed hemodialysis grafts. Peripheral AngioJet Clinical Trial. J Vasc Interv Radiol. 1999;10:1195–1205.CrossRefGoogle ScholarPubMed
31.Silva, JA, Ramee, SR, Collins, TJ, et al.Rheolytic thrombectomy in the treatment of acute limb-threatening ischemia: immediate results and six-month follow-up of the multicenter AngioJet registry. Possis Peripheral AngioJet Study Angio Jet Investigators. Cathet Cardiovasc Diagn. 1998;45:386–393.3.0.CO;2-Q>CrossRefGoogle Scholar
32.Mathie, AG, Bell, SD, Saibil, EA. Mechanical thromboembolectomy in acute embolic peripheral arterial occlusions with use of AngioJet Rapid Thrombectomy System. J Vasc Interv Radiol. 1999;10:583–590.CrossRefGoogle ScholarPubMed
33.Bellon, RJ, Putman, CM, Budzik, RF, Pergolizzi, RS, Reinking, GF, Norbash, AM. Rheolytic thrombectomy of the occluded internal carotid artery in the setting of acute ischemic stroke. AJNR Am J Neuroradiol. 2001;22:526–530.Google ScholarPubMed
34.Lutsep, HL. Mechanical thrombolysis in acute stroke. E Medicine. 2001;2:1–7.Google Scholar
35.Lutsep, HL, Campbell, M, Clark, WM, et al.EPAR therapy system for treatment of acute stroke: safety study results [abstract]. Stroke. 2001;32:319b.CrossRefGoogle Scholar
36.Gobin, YP, Starkman, S, Duckwiler, GR, et al.MERCI 1: a phase 1 study of Mechanical Embolus Removal in Cerebral Ischemia. Stroke. 2004;35:2848–2854.CrossRefGoogle ScholarPubMed
37.Nunn, CM, O'Neill, WW, Rothbaum, D, et al.Long-term outcome after primary angioplasty: report from the primary angioplasty in myocardial infarction (PAMI-I) trial. J Am Coll Cardiol. 1999;33:640–646.CrossRefGoogle ScholarPubMed
38.Keeley, EC, Boura, JA, Grines, CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361:13–20.CrossRefGoogle ScholarPubMed
39.Balousek, PA, Knowles, HJ, Higashida, RT, del Zoppo, GJ. New interventions in cerebrovascular disease: the role of thrombolytic therapy and balloon angioplasty. Curr Opin Cardiol. 1996;11:550–557.CrossRefGoogle ScholarPubMed
40.Chung, J, Kwon, S. Endovascular treatment of isolated and severe middle cerebral artery stenosis with percutaneous balloon and stenting. Abstract presented at: Annual Meeting of the American Society of Neuroradiology. April 23-27, 2001; Boston, Mass.Google Scholar
41.Mori, T, Kazita, K, Mima, T, Mori, K. Balloon angioplasty for embolic total occlusion of the middle cerebral artery and ipsilateral carotid stenting in an acute stroke stage. AJNR. 1999;20:1462–1464.Google Scholar
42.Ringer, AJ, Qureshi, AI, Fessler, RD, Guterman, LR, Hopkins, LN. Angioplasty of intracranial occlusion resistant to thrombolysis in acute ischemic stroke. Neurosurgery. 2001;48:1282–1290.Google ScholarPubMed
43.Levy, El, Ecker, RD, Horowitz, MB, et al.Stent-assisted intracranial recanalization for acute stroke: early results. Neurosurgery. 2006;58:458–463.CrossRefGoogle ScholarPubMed