Treatment for Patients with Acute Ischemic Stroke Presenting beyond Six Hours of Ischemic Symptom Onset : Effectiveness of Intravenous Direct Thrombin Inhibitor, Argatroban

Park, Jung Soo; Park, Seung Soo; Koh, Eun Jeong; Eun, Jong-Pil; Choi, Ha Young

doi:10.3340/jkns.2010.47.4.258

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Worldwide, ischemic stroke accounts for approximately 85% of stroke cases [2]. Hypercoagulation and microthrombi formation, which lead to microvascular occlusion and reduction in blood flow, are important events associated with stroke [3][4][5][6]. Impaired fibrinolysis also play an important role and research has shown that in ischemic stroke patients, there are significantly longer euglobulin clot lysis times, as well as higher levels of plasminogen activator inhibitor-1 and tissue-type plasminogen activator antigen [7].…”

Section: Introductionmentioning

confidence: 99%

Differences in fibrin fiber diameters in healthy individuals and thromboembolic ischemic stroke patients

Pretorius¹,

Steyn

Engelbrecht³

et al. 2011

Blood Coagulation &Amp; Fibrinolysis

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Cerebrovascular disease is one of the leading causes of death and the cause of long-term adult disability. An important characteristic of thromboembolic ischemic stroke is a prothrombotic or hypercoagulable state and altered fibrin clot structure, whereas a resistance to fibrinolysis is also present. An expansive fibrin network is created when adding thrombin, and in stroke, the network appears thickened, netted and matted, compared with that of healthy individuals. Although this is clearly visible in micrographs of patients, there is a need to quantify the changes. The current study, therefore, investigates fibrin fiber diameters in stroke patients and compares it to healthy individuals. The fiber diameters were measured in nanometres, with University of Texas Health Science Center at San Antonio (UTHSCSA) Image Tool. A total of 100 measurements were done for each of the 12 patients in the healthy control group, and the same number of measurements was done for 12 stroke patients. These measurements were statistically analysed with NCSS 2007, using a significance level of 0.05. Normality was assessed with the Shapiro-Wilk W test and the thickest and thinnest fiber of each individual in the two groups was quantified and differences between groups were assessed with the Student's t-test. Results showed that there is a statistical difference in fibrin fiber thickness during thromboembolic ischemic stroke. We conclude that the changed coagulation and hemostasis, typically associated with stroke, causes a statistically relevant change in fibrin thickness, and that this netted and matted network is more resistant to lyses.

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Section: Introductionmentioning

confidence: 99%

Differences in fibrin fiber diameters in healthy individuals and thromboembolic ischemic stroke patients

Pretorius¹,

Steyn

Engelbrecht³

et al. 2011

Blood Coagulation &Amp; Fibrinolysis

View full text Add to dashboard Cite

show abstract

“…Argatroban, a selective direct thrombin inhibitor, has been adopted to treat acute ischemic stroke [ 8 ]. Preclinical [ 9 , 10 ] and clinical [ 11 , 12 ] studies have indicated that argatroban is effective in treating acute ischemic stroke without increasing hemorrhage in the brain. In rat models, argatroban increased blood flow to the lesion area, reduced secondary microthrombi formation, and decreased neurologic deficit [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Argatroban Increased the Basal Vein Drainage and Improved Outcomes in Acute Paraventricular Ischemic Stroke Patients

Liu

et al. 2020

Med Sci Monit

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Background Since venous drainage in acute arterial ischemic stroke has not been thoroughly researched, we evaluate the effect of argatroban, a selective direct thrombin inhibitor, as a therapy to increase the rate of basal vein Rosenthal (BVR) drainage and improve patients’ post-stroke outcomes. Material/Methods In this multicenter clinical trial, 60 eligible patients at 4.5 to 48 hours after the stroke onset were recruited. After being randomly allocated into 2 groups, they were treated with standard therapy either alone or with argatroban. Results Compared to the contralateral brain hemisphere, the mean flow velocity (MFV) in BVR drainage was significantly reduced in the stroke-afflicted ipsilateral hemisphere. After treatment with argatroban for 7 days, the MFV from BVR of the ipsilateral hemisphere in the argatroban treated group was significantly increased when compared to the control group. At 90 days after the onset of stroke, the MFV of BVR in the ipsilateral hemisphere was similar in both groups. Compared with controls, the argatroban-treated patients had smaller lesions from baseline to 7 days. Argatroban also improved National Institutes of Health Stroke Scale (NIHSS) scores on day 7 after the onset of stroke. Furthermore, the argatroban group’s neurological functions were superior to those of their untreated counterparts after 90 days. No difference was found in the incidence of adverse reactions between the 2 groups. Conclusions These observations indicate that vein drainage change may contribute to the acute phase of brain edema and the outcomes of ischemic stroke patients. Clinical Trial Registration URL- http://www.chictr.org Unique identifier: ChiCTR-IPR-16008663

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Efficacy and safety of argatroban in treatment of acute ischemic stroke: A meta-analysis

Lv¹,

Guo²,

Lin³

et al. 2022

WJCC

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Treatment for Patients with Acute Ischemic Stroke Presenting beyond Six Hours of Ischemic Symptom Onset : Effectiveness of Intravenous Direct Thrombin Inhibitor, Argatroban

Cited by 5 publications

References 24 publications

Differences in fibrin fiber diameters in healthy individuals and thromboembolic ischemic stroke patients

Differences in fibrin fiber diameters in healthy individuals and thromboembolic ischemic stroke patients

Argatroban Increased the Basal Vein Drainage and Improved Outcomes in Acute Paraventricular Ischemic Stroke Patients

Efficacy and safety of argatroban in treatment of acute ischemic stroke: A meta-analysis

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