Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA).
A group of 59 patients with stroke due to acute vertebrobasilar or carotid territory occlusion have been treated by local intra-arterial fibrinolysis (LIF). A high recanalisation rate was accomplished with either urokinase or recombinant tissue plasminogen activator (r-TPA). However, with either substance, even if a high dose was used, recanalisation was a time-consuming process which usually took 120 min. A reasonable explanation for the lack of effectiveness of these plasminogen-activating substances might be a deficit of substrate, e.g. plasminogen, in aged thrombus. LIF was capable of improving clinical outcome in acute vertebrobasilar artery occlusion, reducing mortality to 50% in patients fulfilling inclusion criteria. In the carotid territory multiple occlusions had a poor prognosis while good clinical results could be achieved in occlusions of the proximal middle cerebral artery or single branches.
Zeumer
H
H
Department of Neuroradiology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany.
Freitag
H J
HJ
Zanella
F
F
Thie
A
A
Arning
C
C
D002341:Carotid Artery Thrombosis / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000188:drug therapy; D015641:Radiography, Interventional; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy
D014568:Urokinase-Type Plasminogen Activator