Fibrinolytic Agents

Publication Title: 
Hematology/Oncology Clinics of North America

Statin drugs and various isoprenoids from plant origins inhibit mevalonic acids, cholesterol, and other isoprenoid products. Among these, reduction of farnesyl and geranylgeranyl prenylated proteins impedes signal transduction at the cellular level. The authors envision that limiting such prenylated proteins downregulates thrombin-stimulated events, including decreasing the expression and availability of protease-activated receptor-1 mitigating thrombin stimulation of cells, tissue factor preventing additional thrombin generation, and plasminogen activator inhibitor-1 allowing thrombosis.

Author(s): 
Fenton, J. W.
Shen, G. X.
Minnear, F. L.
Brezniak, D. V.
Jeske, W. P.
Walenga, J. M.
Bognacki, J. J.
Ofosu, F. A.
Hassouna, H. I.
Publication Title: 
Metabolic Syndrome and Related Disorders

Several experimental studies and some clinical experience have shown that metabolic syndrome and caloric restriction exert opposite effects on thrombosis, because these two nourishing conditions are at extreme ends of the same spectrum. The antithrombotic action induced by caloric restriction happens through Sirtuin 1 (SIRT1), a gene/protein activated by the reduction of calorie intake lower than is typical. The antithrombotic effect is due to the activation of SIRT1 acting through an increase of insulin sensitivity, which reduces endothelial dysfunction.

Author(s): 
Cacciapuoti, Federico
Publication Title: 
Arzneimittel-Forschung

The pharmacological effects of the new platelet aggregation inhibitor cilostazol (6-(4-(1-cyclohexyl-1 H-tetrazol-5-yl)butoxy]-3,4-dihydro-2(1H)-quinolinone, OPC-13013) on the central nervous system were studied. Cilostazol had little effect on the general behavior of mice up to a dose of 1000 mg/kg p.o. and caused disappearance of pinna reflex, alertness and startle response and slight ptosis in only one of 6 rats at a dose of 1000 mg/kg p.o.

Author(s): 
Shintani, S.
Toba, Y.
Suzuki, S.
Ninomiya, S.
Umezato, M.
Hiyama, T.
Publication Title: 
Platelets

Terminalia arjuna (TA) is a medicinal plant used as a cardiotonic in ayurveda. Besides others, scientific evidence dictates its strong hypolipidemic and antioxidant properties. However, anti-inflammatory and antiplatelet aggregatory properties of TA are not known. The present study demonstrates in vitro effects of its ethanolic bark extract (TAE) on platelet function indices. Twenty patients of angiographically proven coronary artery disease (CAD) were included in Group I and 20 age and sex-matched controls were included in Group II.

Author(s): 
Malik, Namita
Dhawan, Veena
Bahl, Ajay
Kaul, Deepak
Publication Title: 
Langenbecks Archiv Für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Für Chirurgie. Kongress

Between 1983 und 1991, emergency pulmonary embolectomy with the aid of extracorporeal circulation was performed in 13 patients. Ten patients were in class IV according to Greenfield, seven came into the operating theater with external cardiac massage. The 30-day mortality was 46%. In the same period, 15 venous interruption procedures were performed (three Adams de Weese Clip, ten Greenfield-Filter, and two femoral vein ligations). Eight times the venous interruption procedure was done prophylactically.

Author(s): 
Leitz, K. H.
Tsilimingas, N.
Reichert, K.
Publication Title: 
Der Anaesthesist

Adverse effects of resuscitation due to closed-chest cardiac massage are common, and the incidence is increased when an incorrect technique is used. Nevertheless, thrombolytic therapy of a myocardial infarction can become necessary even after cardiopulmonary resuscitation (CPR). In these patients, the risk of thrombolytic therapy-induced bleeding is immanent. CASE REPORTS. Within 9 months, two male patients aged 44 and 52 years were admitted to the intensive care unit after out-of-hospital CPR for myocardial infarction with cardiac arrest.

Author(s): 
Adams, H. A.
Schmitz, C. S.
Block, G.
Schlichting, C.
Publication Title: 
Angiology

The authors present three case reports retrospectively casting doubt on the benefit of thrombolysis after external cardiac massage.

Author(s): 
Cafri, C.
Gilutz, H.
Ilia, R.
Abu-ful, A.
Battler, A.
Publication Title: 
Klinische Monatsblätter Für Augenheilkunde

BACKGROUND: Goal of our study was the comparison of the efficacy of various minimal invasive therapeutic regimens for clinically complete central retinal artery occlusion (CRAO) and the comparison with the literature. PATIENTS AND METHODS: In a retrospective study 93 patients treated for CRAO during the period 1994-1998 were identified. 65 of these patients with clinically complete occlusion without a cilioretinal artery were included in the study. Analysis focused on the results of different therapies and the duration of visual impairment till starting treatment.

Author(s): 
Neubauer, A. S.
Mueller, A. J.
Schriever, S.
Grüterich, M.
Ulbig, M.
Kampik, A.
Publication Title: 
Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie

BACKGROUND: The natural course of central retinal artery occlusion (CRAO) often leads to legal blindness in the affected eye. To date, none of the conservative therapies had proven effective in retrospective studies. In 1991, a new minimally invasive therapy was started in patients with an acute CRAO. This therapy, namely, local intra-arterial fibrinolysis, is comparable to the minimally invasive therapy in patients with an acute ischemic stroke. In pilot studies, it showed promising results in comparison with conservative treatments.

Author(s): 
Feltgen, N.
Neubauer, A.
Jurklies, B.
Schmoor, C.
Schmidt, D.
Wanke, J.
Maier-Lenz, H.
Schumacher, M.
EAGLE-Study Group
Publication Title: 
Current Opinion in Ophthalmology

PURPOSE OF REVIEW: Numerous therapeutic options have been suggested for the treatment of central retinal artery occlusion (CRAO) such as ocular massage, anterior chamber paracentesis, physical exercise, and medication-induced reduction of intraocular pressure. Because of the lack of a proven effective treatment for CRAO, there has been a strong effort to develop alternative therapies. Recently, thrombolytic therapy has been suggested as a viable therapy for CRAO. The aim of this review is to provide an update on the progress of thrombolytic therapy for CRAO.

Author(s): 
Hazin, Ribhi
Dixon, James A.
Bhatti, M. Tariq

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