Effect of intra-arterial tissue plasminogen activator and urokinase on autologous arterial emboli in the cerebral circulation of rabbits [corrected].
We conducted a randomized, blinded controlled trial to test the efficacy of fibrinolytic therapy with tissue plasminogen activator and urokinase in the treatment of acute embolic stroke. Embolic stroke was simulated in rabbits by injecting three 0.5 x 0.5 mm fragments of autologous arterial thrombus harvested from a traumatized auricular artery. Thirty minutes after embolization the rabbits were blindly treated with tissue plasminogen activator (n = 21), urokinase (n = 20), or 0.9% saline (n = 20). At 6 hours the rabbits were sacrificed, and the cerebral vasculature was inspected for the location and number of emboli. The brain was then cut into 0.5-cm-thick coronal sections and stained with triphenyltetrazolium chloride to define areas of infarction. Treatment with either tissue plasminogen activator or urokinase significantly reduced the number of emboli present in the cerebral circulation (p less than 0.05). The area of ischemic injury was also significantly reduced (p less than 0.05) by acute fibrinolytic therapy with either tissue plasminogen activator or urokinase. However, only treatment with tissue plasminogen activator significantly reduced (p less than 0.05) the incidence of infarction. There was no evidence of intracerebral hemorrhage in any rabbit. Early fibrinolytic therapy improved outcome in this model of acute embolic stroke.
Benes
V
V
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ 85013-4496.
Zabramski
J M
JM
Boston
M
M
Puca
A
A
Spetzler
R F
RF
D000818:Animals; D002544:Cerebral Infarction / Q000150:complications / Q000188:drug therapy; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000150:complications / Q000188:drug therapy*; D004195:Disease Models, Animal; D007261:Infusions, Intra-Arterial; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000188:drug therapy*; D011817:Rabbits; D012449:Safety; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator