title: Results of a multicentre, randomised controlled trial of intra-arterial urokinase in the treatment of acute posterior circulation ischaemic stroke.
abstract: BACKGROUND
  Patients with ischaemic stroke due to occlusion of the basilar or vertebral arteries may develop a rapid deterioration in neurological status leading to coma and often to death. While intra-arterial thrombolysis may be used in this context, no randomised controlled data exist to support its safety or efficacy.
  
  
  METHODS
  Randomised controlled trial of intra-arterial urokinase within 24 h of symptom onset in patients with stroke and angiographic evidence of posterior circulation vascular occlusion.
  
  
  RESULTS
  Sixteen patients were randomised, and there was some imbalance between groups, with more severe strokes occurring in the treatment arm. A good outcome was observed in 4 of 8 patients who received intra-arterial urokinase compared with 1 of 8 patients in the control group.
  
  
  CONCLUSIONS
  These results support the need for a large-scale study to establish the efficacy of intra-arterial thrombolysis for acute basilar artery occlusion.
authors.affiliation: National Stroke Research Institute, Melbourne, Australia. malcolm@apoptosis.freeserve.co.uk
authors.forename: M R
authors.initials: MR
authors.lastname: Macleod
authors.forename: S M
authors.initials: SM
authors.lastname: Davis
authors.forename: P J
authors.initials: PJ
authors.lastname: Mitchell
authors.forename: R P
authors.initials: RP
authors.lastname: Gerraty
authors.forename: G
authors.initials: G
authors.lastname: Fitt
authors.forename: G J
authors.initials: GJ
authors.lastname: Hankey
authors.forename: E G
authors.initials: EG
authors.lastname: Stewart-Wynne
authors.forename: D
authors.initials: D
authors.lastname: Rosen
authors.forename: J J
authors.initials: JJ
authors.lastname: McNeil
authors.forename: C F
authors.initials: CF
authors.lastname: Bladin
authors.forename: B R
authors.initials: BR
authors.lastname: Chambers
authors.forename: G K
authors.initials: GK
authors.lastname: Herkes
authors.forename: D
authors.initials: D
authors.lastname: Young
authors.forename: G A
authors.initials: GA
authors.lastname: Donnan
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy*; D017741:Survivors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator