Acute stroke intervention with intraarterial urokinase infusion.
OBJECTIVE
A preliminary evaluation of the efficacy and safety of treating patients with acute stroke with intraarterial urokinase infusions was performed.


METHODS
Twelve patients with acute stroke were treated within 8 hours of symptom onset (average, 5 hours). Thrombolysis was performed within the middle cerebral (n = 10), internal carotid (n = 1), and basilar (n = 1) arteries. Urokinase (160,000-500,000 IU) was infused through microcatheters placed into or adjacent to the thrombi.


RESULTS
Thrombolysis was angiographically successful in nine patients (75%), all of whom had long-term neurologic improvement. No or minimal neurologic deficits were present in six patients (50%). Thrombolysis failed in three patients (25%); one patient died and two developed severe permanent neurologic deficits. No hemorrhagic complications occurred.


CONCLUSIONS
Preliminary results suggest that intraarterial urokinase infusion may be effective and safe for treating patients with acute stroke. Potentially devastating neurologic damage was averted or lessened in nine patients (75%). No additional neurologic damage was caused by intervention in the remaining three patients (25%).
Barr
J D
JD
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA.
Mathis
J M
JM
Wildenhain
S L
SL
Wechsler
L
L
Jungreis
C A
CA
Horton
J A
JA
D002533:Cerebral Angiography; D002536:Cerebral Arteries; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000517:prevention & control; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
D014568:Urokinase-Type Plasminogen Activator