Lys-plasminogen as an adjunct to local intra-arterial fibrinolysis for carotid territory stroke: laboratory and clinical findings.
To improve the efficacy of local intraarterial fibrinolysis (LIF), we compared different fibrinolytic drugs in a cerebral circulation model in the laboratory. The technical efficacy of fibrinolysis, defined as the clot volume lysed per unit time, was found to be optimal with r-tissue plasminogen activator (TPA) activated lys-plasminogen (= plasmin). Subsequently, 20 patients with stroke due to carotid artery territory occlusion were treated by local intraarterial fibrinolysis using the plasmin regimen. The angiographic data and clinical outcome of these patients were compared with those of 40 patients who received plasminogen activators (urokinase or r-TPA) only. Laboratory and clinical data confirmed that plasmin lysis is superior to treatment using only plasminogen activators.
Freitag
H J
HJ
Department of Neuroradiology, University Hospital Eppendorf, Hamburg, Germany.
Becker
V U
VU
Thie
A
A
Tilsner
V
V
Philapitsch
A
A
Schwarz
H P
HP
Webhof
U
U
Müller
A
A
Zeumer
H
H
D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002533:Cerebral Angiography; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D007261:Infusions, Intra-Arterial; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008955:Models, Cardiovascular; D010446:Peptide Fragments / Q000008:administration & dosage*; D010958:Plasminogen / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D010446:Peptide Fragments; D011994:Recombinant Proteins; C018998:lysyl-plasminogen; D010958:Plasminogen; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator