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[Intraarterial urokinase infusion therapy with superselective catheterization for acute occlusive cerebrovascular
1Department of Radiology, Kita Ishikai Hospital.
Insights
Superselective intraarterial urokinase infusion effectively recanalized arteries in 82% of acute cerebrovascular disease patients. This treatment led to favorable outcomes in 64%, with many discharged neurologically intact.
Area of Science:
- Neurology
- Interventional Radiology
Background:
- Acute occlusive cerebrovascular disease requires timely intervention.
- Intraarterial thrombolysis offers a targeted approach to restore blood flow.
Observation:
- Eleven patients with acute occlusive cerebrovascular disease underwent superselective intraarterial urokinase infusion.
- The study included patients with middle cerebral artery and basilar artery occlusions.
- Treatment was initiated within 3.5 to 9 hours of symptom onset.
Findings:
- Arterial recanalization was achieved in nine out of eleven patients (82%).
- A favorable clinical outcome was observed in seven patients (64%), with six discharged without neurological deficits.
- Two patients experienced hemorrhagic infarction, but without clinical deterioration.
Implications:
- Intraarterial urokinase infusion with superselective catheterization shows significant promise for acute occlusive cerebrovascular disease.
- This therapeutic strategy may be a valuable option in the hyperacute treatment window.
- Further research can explore optimal dosing and patient selection for this intervention.
Abstract:
Intraarterial urokinase infusion therapy with superselective catheterization was performed on 11 patients for acute occlusive cerebrovascular disease. The subjects were five men and six women with a mean age of 70 years (range, 48-83 years). Nine of 11 patients had middle cerebral artery occlusion and two had basilar artery occlusion. The interval from onset to infusion ranged from 3.5 to 9 hours, and the total dosage of urokinase from 24 x 10(4) to 150 x 10(4) IU. Recanalization of the occluded artery was achieved in nine patients (82%), and favorable clinical outcome was achieved in seven patients (64%). Six of whom were discharged with no neurologic deficits. Hemorrhagic infarction occurred in two patients without clinical deterioration. Our observations suggest that intraarterial urokinase infusion therapy with superselective catheterization may be very useful in the acute stage of occlusive cerebrovascular disease.