title: Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA).
abstract: 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.
authors.affiliation: Department of Neuroradiology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany.
authors.forename: H
authors.initials: H
authors.lastname: Zeumer
authors.forename: H J
authors.initials: HJ
authors.lastname: Freitag
authors.forename: F
authors.initials: F
authors.lastname: Zanella
authors.forename: A
authors.initials: A
authors.lastname: Thie
authors.forename: C
authors.initials: C
authors.lastname: Arning
mesh_terms: 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
chemical_list: D014568:Urokinase-Type Plasminogen Activator