Home
My Account
About Us
Forum
Contact us
الواجهة العربية
epharmaweb.com
Medical News Medical News
Aricles Articles
Events Events
Guidelines Guidelines
Videos Library Videos Library
Diseases Diseases
Follow us : facebook twitter Digg Linkedin Boxiz
Newsletter

Please select the categories you are intersted in:
News Articles Guidelines Events Videos Journals' abstracts

Latest Subscribers
Advanced Search »



Low-Dose Recombinant Tissue-Type Plasminogen Activator Enhances Clot Resolution in Brain Hemorrhage



Low-Dose Recombinant Tissue-Type Plasminogen Activator Enhances Clot Resolution in Brain Hemorrhage

Neal Naff, MD; Michael A. Williams, MD; Penelope M. Keyl, PhD; Stanley Tuhrim, MD; M. Ross Bullock, MD; Stephan A. Mayer, MD; William Coplin, MD; Raj Narayan, MD; Stephen Haines, MD; Salvador Cruz-Flores, MD; Mario Zuccarello, MD; David Brock, MD; Issam Awad, MD; Wendy C. Ziai, MD, MPH; Anthony Marmarou, PhD; Denise Rhoney, PharmD; Nichol McBee, MPH, CCRP; Karen Lane, CCRP; Daniel F. Hanley Jr, MD

The Stroke,
42:11, August 25, 2011

Low-Dose Recombinant Tissue-Type Plasminogen Activator Enhances Clot Resolution in Brain Hemorrhage

Background and Purpose
Patients with intracerebral hemorrhage and intraventricular hemorrhage have a reported mortality of 50% to 80%. We evaluated a clot lytic treatment strategy for these patients in terms of mortality, ventricular infection, and bleeding safety events, and for its effect on the rate of intraventricular clot lysis.

Methods
Forty-eight patients were enrolled at 14 centers and randomized to treatment with 3 mg recombinant tissue-type plasminogen activator (rtPA) or placebo. Demographic characteristics, severity factors, safety outcomes (mortality, infection, bleeding), and clot resolution rates were compared in the 2 groups.

Results
Severity factors, including admission Glasgow Coma Scale, intracerebral hemorrhage volume, intraventricular hemorrhage volume, and blood pressure were evenly distributed, as were adverse events, except for an increased frequency of respiratory system events in the placebo-treated group. Neither intracranial pressure nor cerebral perfusion pressure differed substantially between treatment groups on presentation, with external ventricular device closure, or during the active treatment phase. Frequency of death and ventriculitis was substantially lower than expected and bleeding events remained below the prespecified threshold for mortality (18% rtPA; 23% placebo), ventriculitis (8% rtPA; 9% placebo), symptomatic bleeding (23% rtPA; 5% placebo, which approached statistical significance; P=0.1). The median duration of dosing was 7.5 days for rtPA and 12 days for placebo. There was a significant beneficial effect of rtPA on rate of clot resolution.

Conclusions
Low-dose rtPA for the treatment of intracerebral hemorrhage with intraventricular hemorrhage has an acceptable safety profile compared to placebo and historical controls. Data from a well-designed phase III clinical trial, such as CLEAR III, will be needed to fully evaluate this treatment.







اضغط هنا للقراءة باللغة العربية

Prepared by: Dr. Awss Zidan






Forgot your password


sign up

Consultants Corner

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist
Poll

Which of the following you are mostly interested in?

Cancer Research
Mental Health
Heart Disease & Diabetes
Sexual Health
Obesity and Healthy Diets
Mother & Child Health

Disclaimer : This site does not endorse or recommend any medical treatment, pharmaceuticals or brand names. More Details