[Extravasation of contrast medium in local intra-arterial fibrinolysis of the carotid territory].
The safety of fibrinolytic therapy is determined with the incidence of intraparenchymatous hemorrhage. When interpreting CT studies after local intra-arterial fibrinolysis (LIF) in the carotid territory, one must consider that a hyperdense lesion may also be caused by extravasation of contrast material during angiography. In this study we retrospectively analyzed CT scans of 24 patients performed within 24 h after LIF and correlated the results with clinical and angiographic findings before and after therapy. Three of 24 patients (12.5%) showed striatocapsular parenchymal hematomas, 2 patients died and 1 showed marked clinical deterioration. Fifteen of 24 patients (62.5%) showed hyperdense lesions without space-occupying effect within striatocapsular infarctions. In 6 of these patients (25%) these lesions were attributable to an extravasation of contrast medium during angiography. This extravasation required at least partial recanalization of the middle cerebral artery and always occurred within a striatocapsular infarction. The pathogenesis of extravasation of contrast medium during local intra-arterial fibrinolysis is unknown. The identification of these lesions, however, is essential for the assessment of safety of local intra-arterial fibrinolysis.
Urbach
H
H
Neuroradiologie, Radiologische Klinik, Universität, Bonn.
Bendszus
M
M
Brechtelsbauer
D
D
Solymosi
L
L
D000328:Adult; D015901:Angiography, Digital Subtraction; D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy; D003342:Corpus Striatum / Q000098:blood supply / Q000000981:diagnostic imaging; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects
D014568:Urokinase-Type Plasminogen Activator