Thrombolytic therapy for delayed, in-hospital stroke after cardiac surgery.
Five patients who had delayed stroke after cardiac surgery underwent intraarterial administration of a fibrinolytic agent for thromboembolism (n = 4) or thrombosis (n = 1) of the cerebral artery. Complete recanalization of the occluded artery was obtained in 3 patients and partial recanalization in 2. Additional angioplasty for basilar artery stenosis was performed in 1 patient. No patients exhibited rebleeding into the pericardial space or wound bleeding. All patients survived with moderate or full functional recovery. Immediate cerebral angiography and local thrombolysis may improve functional outcome and survival in patients with postcardiotomy cerebral thromboembolism.
Fukuda
Ikuo
I
Department of Surgery I, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. ikuofuku@cc.hirosaki-u.ac.jp
Imazuru
Tomohiro
T
Osaka
Motoo
M
Watanabe
Ko
K
Meguro
Kotoo
K
Wada
Mitsuyosi
M
D000368:Aged; D006348:Cardiac Surgical Procedures; D002533:Cerebral Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator