title: Intra-arterial thrombolysis: tissue plasminogen activator and other thrombolytic agents.
abstract: Recanalization rates with the administration of intravenous tissue plasminogen activator in acute ischemic stroke are low. Adjuvant endovascular techniques that achieve recanalization by direct intra-arterial (IA) delivery of thrombolytics, mechanical clot retrieval, clot aspiration, and stenting may complement intravenous pharmacotherapy. IA thrombolytics can be administered within 6 hours of symptom onset in anterior circulation strokes and within 24 hours in posterior circulation strokes. This review describes the indications, patient selection, and technique for IA administration of thrombolytics.
authors.affiliation: Department of NeuroInterventional Surgery, Baptist Cardiac and Vascular Institute, Miami, FL 33176, USA.
authors.forename: Edgar A
authors.initials: EA
authors.lastname: Samaniego
authors.forename: Italo
authors.initials: I
authors.lastname: Linfante
authors.forename: Guilherme
authors.initials: G
authors.lastname: Dabus
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007269:Injections, Intra-Arterial; D011994:Recombinant Proteins / Q000008:administration & dosage; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator