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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Fibrinolytic therapy in intraventricular hemorrhage
1Department of Pharmacy Practice, College of Pharmacy, The University of Illinois at Chicago, 60612-7329, USA. coandrews1@juno.com
The Annals of Pharmacotherapy
|November 29, 2001
Summary
Intraventricular fibrinolytic therapy for intraventricular hemorrhage (IVH) may reduce mortality by 30-35%. Further research is needed to optimize treatment and confirm improved neurological outcomes in patients with IVH.
Area of Science:
- Neuroscience
- Pharmacology
Background:
- Intraventricular hemorrhage (IVH) carries a poor prognosis due to clot burden and limited endogenous fibrinolysis.
- Cerebrospinal fluid's natural fibrinolytic system is insufficient to clear intraventricular clots.
- External ventricular drains, a primary management, are prone to occlusion by coagulated blood.
Purpose of the Study:
- To review existing literature on using fibrinolytic agents for IVH treatment.
- To assess the efficacy and safety of intraventricular fibrinolysis in managing IVH.
Main Methods:
- Extensive literature search of MEDLINE, EMBASE, and Conference Proceedings (1966-2000).
- Screening of bibliographies of identified articles.
- Inclusion of studies detailing intraventricular administration of fibrinolytic agents for IVH.
Main Results:
- Fibrinolytic agents like alteplase and urokinase (u-PA) have been administered intraventricularly to dissolve clots.
- Complications include infection and potential rebleeding.
- Clinical studies indicate a 30-35% reduction in mortality with fibrinolytic therapy for IVH.
Conclusions:
- Intraventricular fibrinolytic therapy may be life-saving in severe IVH cases.
- Optimal dosing, frequency, and administration methods require further investigation.
- Randomized, placebo-controlled trials are necessary to definitively assess the value of this therapy.
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