UT Stroke
Argatroban
Inclusion Criteria
- Ischemic stroke symptoms with onset <3 hours. Symptoms must be distinguished from another ischemic event such as syncope, seizure, migraine, and hypoglycemia.
- Males and females ages 18-85 years.
- A clot causing complete or partial occlusion (TIBI 0, 1, 2, or3) via TCD in any one of the following areas: distal ICA, MCA (M1 or M2), PCA (P1 or P2) distal vertebral or basilar occlusions.
- Meet criteria for rT-PA therapy.
Exclusion Criteria
- Evidence of intracranial hemorrhage (ICH) on baseline CT scan or non-vascular cause of neurological deficit.
- Baseline NIHSS >5 or patient with rapidly resolving deficit or rapidly improving symptoms consistent with TIA.
- Pre-existing disability with mRS≥2
- Absent temporal windows on TCD
- Previous stroke, myocardial infarction (MI), post myocardial infarction, pericarditis, intracranial surgery, or documented head trauma within 3 months of baseline.
IMS-III
Inclusion Criteria
- Age: 18 through 80 years (i.e., candidates must have had their 18th birthday, but not had their 81st birthday)
- Initiation of intravenous rt-PA within 3 hours of onset of stroke symptoms. Time of onset is defined as the last time when the subject was witnessed to be at baseline (i.e., subjects who have stroke symptoms upon awakening will be considered to have their onset at beginning of sleep)
- An NIHSSS ≥ 10 at the time that intravenous rt-PA is begun
Exclusion Criteria
- History of stroke in the past 3 months
- Previous intra-cranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arteriovenous malformation
- Hypertension at time of treatment; systolic BP > 185 or diastolic > 110 mm Hg) or aggressive measures to lower blood pressure to below these limits are needed.
- Recent (within 30 days) surgery or biopsy of parenchymal organ or hemorrhage
- Recent (within 90 days) severe head trauma or head trauma with loss of consciousness
- Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency or oral anticoagulant therapy with INR > 1.7 or institutionally equivalent prothrombin time
TNK-S2B
Inclusion Criteria
- Patients with at least a serious, measurable deficit on the NIH Stroke Scale in:
- language (aphasia score ± 1)
- motor power (arm or leg ± 1)
- vision (best visual score ± 2)
- attention (attention score ± 2)
- Must arrive at participating hospital and treatment begun within 3 hours of the onset of symptoms. Patients awakening with new symptoms must use the time of onset as the time last observed to be normal and awake and the total time cannot exceed three hours prior to treatment.
- Must be 18 years of age or older.
MR RESCUE
Inclusion Criteria
- New focal disabling neurologic deficit consistent w/ acute cerebral ischemia (NIHSS ≥ 6)
- Age ≥ 18 ≤ 85
- Clot retrieval procedure can be initiated within 8 hours from onset
- Large vessel (proximal anterior circulation) occlusion on MR angiography in a target vessel (internal carotid, M1 or M2 MCA)
- Informed consent signed by the patient or patient’s legally representative
- Pretreatment MRI performed according to MR RESCUE protocol
- Premorbid modified Rankin score of 0-1
- **patients who “failed” IV tPA w/ persistent target occlusion per a MR RESCUE protocol MRI (MRI must be done post IV tPA infusion)
Exclusion Criteria
- History of stroke in the past 3 months
- Previous intra-cranial hemorrhage, neoplasm, subarachnoid hemorrhage, or arteriovenous malformation
- Hypertension at time of treatment; systolic BP > 185 or diastolic > 110 mm Hg) or aggressive measures to lower blood pressure to below these limits are needed.
- Recent (within 30 days) surgery or biopsy of parenchymal organ or hemorrhage
- Recent (within 90 days) severe head trauma or head trauma with loss of consciousness
- Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency or oral anticoagulant therapy with INR > 1.7 or institutionally equivalent prothrombin time
