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Acute ischemic stroke (AIS) is a life-threatening thrombotic disorder, with intravenous thrombolysis (IVT) serving as the first-line treatment during its acute phase. However, thrombolysis resistance diminishes the success rate of early reperfusion. Recent studies have highlighted neutrophil extracellular traps (NETs) as a critical factor contributing to thrombolysis resistance. Targeting NETs with deoxyribonuclease I (DNase I) has been shown to significantly improve the thrombolytic efficacy of recombinant tissue plasminogen activator (rt-PA) and reduce the risk of hemorrhagic transformation. In this review, we summarize current knowledge on the mechanisms by which NETs contribute to thrombosis and thrombolysis resistance, explore the prospective and feasibility of targeting NETs to improve thrombolysis, providing information about the creation of innovative thrombolytic treatment approaches for AIS.
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http://dx.doi.org/10.1055/a-2609-3457 | DOI Listing |
Transl Stroke Res
September 2025
Department of Neurology, Aarhus University Hospital, Palle Juul Jensens Boulevard 165, Entrance J 518, 8200, Aarhus N, Aarhus, Denmark.
Remote ischemic conditioning (RIC) is a simple, non-invasive procedure that has been shown to be safe and feasible in multiple smaller clinical trials. Recent large randomized controlled trials have yielded mixed results regarding clinical effect. Patients with severe stroke may experience greater benefit from cerebroprotective interventions, highlighting the need for adjunctive therapies to enhance endovascular therapy (EVT) outcomes.
View Article and Find Full Text PDFEur J Radiol
August 2025
Department of Interventional and Vascular Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, PR China. Electronic address:
Purpose: To determine predictors of immediate thrombolysis resistance (iTR) in patients with proximal deep vein thrombosis (DVT), defined as thrombosis involving the femoral or more proximal veins, with or without concomitant popliteal vein involvement, and to investigate its impact on long-term post-thrombotic syndrome (PTS) outcomes.
Methods: This single-center retrospective study reviewed consecutive patients who underwent catheter-directed thrombolysis (CDT) as first-line therapy. Baseline demographics, clinical history, comorbidities and provoking risk factors for DVT, intraprocedural findings, periprocedural complications, and follow-up outcomes were compared between the iTR and immediate thrombolysis success (iTS) groups.
Neuroscience
August 2025
Normandie University, UNICAEN, INSERM UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), 14000 Caen, France; Department of Neurology, Caen-Normandie University Hospital, CHU, Caen, France.
Recombinant tissue plasminogen activator (alteplase) and its derivative tenecteplase are approved for acute ischemic stroke (AIS), but their low recanalization rates remain a limitation. Resistance to intravenous (IV) fibrinolysis may arise from platelet cross-linking during arterial thrombosis, mediated by von Willebrand factor (VWF) multimers. N-Acetylcysteine (NAC) has demonstrated potential to cleave large VWF multimers in preclinical studies, suggesting its potential as an adjunct therapy.
View Article and Find Full Text PDFCureus
July 2025
Cardiology Unit, National Hospital of Sri Lanka, Colombo, LKA.
Acute pulmonary thromboembolism represents a critical, life-threatening condition that necessitates immediate and effective management to minimize associated mortality. Although the current recommendation for managing hemodynamically unstable pulmonary embolism (PE) is the regimen of 100 mg recombinant tissue plasminogen activator (rtPA) administered over two hours, an accelerated regimen of rtPA (0.6 mg/kg over 15 minutes, maximum 50 mg) has also been described for the management of PE and circulatory arrest.
View Article and Find Full Text PDFActa Biomater
August 2025
Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, USA. Electronic address:
Cardiovascular diseases and stroke together account for the largest causes of death in Western countries. These pathologies are directly linked to the formation of blood clots that block blood flow to vital organs. Common risk factors for such clots are obesity, high blood pressure, diabetes, and high LDL cholesterol.
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