title: Thrombolytic therapy of cerebral arterial occlusion with recombinant tissue plasminogen activator.
abstract: This report describes three patients, with acute cerebral arterial occlusion, treated with recombinant tissue plasminogen activator (rt-PA). In one patient with basilar artery occlusion thrombolytic treatment was initiated 12 h after onset of the symptoms. In two patients with angiographically verified occlusion of the middle cerebral artery, the treatment was initiated approximately 4.5 h after onset of the symptoms. Recombinant tissue plasminogen activator 80-120 mg, was infused intra-arterially over 90-100 min via a catheter the tip of which was close to the occlusion. This regimen resulted in recanalization in all the patients; however, in two patients it was verified by repeat CT scan only. In two patients the thrombolytic treatment was successful (the patients improved clinically); the third patient died of massive cerebral infarct-related oedema. In none of the patients did significant bleeding or other obvious side-effects occur. From this preliminary report it is concluded that angiographically proven thrombolytic recanalization in acute cerebrovascular occlusion is possible with rt-PA. In some patients, however, the treatment is initiated too late. Further investigation of the possible indication for thrombolytic therapy in stroke is needed.
authors.affiliation: Department of Neurology, University Hospital of Copenhagen, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Overgaard
authors.forename: H
authors.initials: H
authors.lastname: Pedersen
authors.forename: J
authors.initials: J
authors.lastname: Boesen
authors.forename: G
authors.initials: G
authors.lastname: Waldemar
authors.forename: J B
authors.initials: JB
authors.lastname: Knudsen
authors.forename: G
authors.initials: G
authors.lastname: Boysen
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator