title: Direct thrombolytic revascularization of the occluded basilar artery.
abstract: Successful direct revascularization in a 54-year-old man with embolism of the basilar artery following St Jude Medical valve replacement for mitral regurgitation 6 years earlier is reported. He arrived at the hospital in a deep coma. Computed tomography showed no new lesions, but subsequent angiography revealed occlusion of the basilar tip, bilateral posterior cerebral arteries and right superior cerebellar artery. Direct thrombolytic therapy was performed using 420,000 units urokinase through an infusion catheter placed in the basilar artery. The patient immediately regained consciousness, with only slight diplopia. Direct thrombolytic therapy is considered to be an effective treatment for thromboembolism following prosthetic valve replacement in certain selected cases.
authors.affiliation: Second Department of Surgery, Niigata University School of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Hayashi
authors.forename: F
authors.initials: F
authors.lastname: Oguma
authors.forename: H
authors.initials: H
authors.lastname: Miyamura
authors.forename: S
authors.initials: S
authors.lastname: Eguchi
authors.forename: T
authors.initials: T
authors.lastname: Koike
mesh_terms: D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D002533:Cerebral Angiography; D006350:Heart Valve Prosthesis; D006801:Humans; D007269:Injections, Intra-Arterial; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D014568:Urokinase-Type Plasminogen Activator