Efficacy of intra-arterial and intravenous prourokinase in an embolic stroke model evaluated by diffusion-perfusion magnetic resonance imaging.
OBJECTIVE
To explore the utility of intravenous (i.v.) prourokinase treatment, we compared intra-arterial (i.a.) and i.v. delivery in a rat embolic stroke model, using diffusion (DWI) and perfusion (PI) magnetic resonance imaging to assess in vivo effects on ischemic lesion evolution and reperfusion.


BACKGROUND
Thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke is useful during the initial hours after onset. Prourokinase is a novel thrombolytic agent with potential safety advantages in comparison to rt-PA.


METHODS
Twenty-four male Sprague-Dawley rats were embolized with autologous blood clots into the middle cerebral artery territory and then randomly assigned at 30 minutes after embolization to a 2-hour bolus infusion with i.a. prourokinase, i.v. prourokinase, or vehicle. DWI and PI were performed before treatment and repeated during and at the end of the treatment.


RESULTS
PI demonstrated that both i.a. and i.v. significantly improved the percentage of the ischemic hemisphere that was normally perfused when the 20-minute, pretreatment, and 145-minute after embolization time points were compared; in the control group, the hypoperfused volume increased over time. DWI disclosed that the ischemic lesion evolution slightly decreased in the i.a. group, remained stable in the i.v. group, and increased over time in the control group. Infarct volume by triphenyltetrazolium chloride (TTC) staining was significantly smaller in both treatment groups than controls.


CONCLUSIONS
These results demonstrate that i.a. and i.v. therapy with prourokinase are equally effective in promoting reperfusion and inhibiting the development of focal ischemic injury in this rat embolic stroke model.
Takano
K
K
Department of Neurology, Memorial Health Care, Worcester, MA 01605, USA.
Carano
R A
RA
Tatlisumak
T
T
Meiler
M
M
Sotak
C H
CH
Kleinert
H D
HD
Fisher
M
M
D000818:Animals; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004195:Disease Models, Animal; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D010960:Plasminogen Activators / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D011994:Recombinant Proteins / Q000494:pharmacology; D015424:Reperfusion / Q000379:methods; D014568:Urokinase-Type Plasminogen Activator / Q000494:pharmacology*
D011994:Recombinant Proteins; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator