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Related Experiment Video

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Defibrinogen Therapy for Acute Ischemic Stroke: 1332 Consecutive Cases.

Jing Chen1, Dalong Sun2, Mingli Liu1

  • 1Departments of Neurology, Shanghai Fifth People's Hospital Affiliated to Fudan University, Minhang District, Shanghai, China.

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|June 24, 2018
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Summary

Defibrinogen therapy shows promise for improving functional recovery in acute ischemic stroke patients. This treatment demonstrated functional improvement with low mortality risks, though further large-scale trials are needed for verification.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Ischemic stroke is a leading cause of disability worldwide.
  • Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) is a standard treatment, but not universally applicable.
  • Alternative therapeutic strategies are needed for ischemic stroke patients.

Purpose of the Study:

  • To evaluate the effectiveness of defibrinogen therapy on functional recovery in ischemic stroke patients.
  • To assess the safety profile of defibrinogen therapy, including intracranial hemorrhage, mortality, and stroke recurrence.
  • To compare the outcomes of defibrinogen therapy with historical controls of rt-PA treatment.

Main Methods:

  • A retrospective analysis of 1332 ischemic stroke patients treated with defibrinogen therapy between 2008 and 2016.
  • Patients received conservative, individualized, multiple-day dosing regimens of defibrinogen therapy.
  • Functional outcomes were assessed using the Barthel Index (BI) and modified Rankin Scale (mRS); safety variables included intracranial hemorrhage, mortality, and stroke recurrence.

Main Results:

  • Functional success rates at 3 and 12 months were 39.84% and 42.23%, respectively.
  • Fifteen patients experienced asymptomatic intracranial hemorrhage; 12 had symptomatic intracranial hemorrhage (sICH) within 14 days.
  • Overall mortality at 12 months was 6.81%, with a 3.22% stroke recurrence rate.

Conclusions:

  • Multiple-day defibrinogen therapy with defibrase can achieve functional improvement in acute ischemic stroke patients.
  • The therapy demonstrated a low risk of mortality compared to similar studies.
  • Further verification through large-scale randomized controlled trials (RCTs) is warranted to confirm efficacy and safety.