Acute stroke intervention with intraarterial urokinase infusion

Area of Science:

• Neurology
• Interventional Radiology
• Vascular Medicine

Background:

• Acute stroke requires rapid intervention to restore cerebral blood flow and minimize neuronal damage.
• Thrombolysis is a critical treatment modality for ischemic stroke.
• Intraarterial thrombolysis offers a targeted approach to clot dissolution.

Purpose of the Study:

• To evaluate the efficacy and safety of intraarterial urokinase infusion for acute stroke.
• To assess the impact of this treatment on neurological deficits and long-term outcomes.

Main Methods:

• Twelve patients with acute stroke received intraarterial urokinase infusions within 8 hours of symptom onset.
• Microcatheters were used to deliver urokinase (160,000-500,000 IU) into the middle cerebral, internal carotid, or basilar arteries.
• Treatment targeted thrombi in major cerebral vessels.

Main Results:

• Angiographic success in thrombolysis was achieved in 75% of patients (9/12).
• Neurological improvement was observed in all patients with successful thrombolysis.
• 50% of patients experienced no or minimal long-term neurologic deficits.
• Thrombolysis failed in 25% of patients, resulting in one death and severe deficits in two.

Conclusions:

• Intraarterial urokinase infusion is a potentially effective and safe treatment for acute stroke.
• The procedure demonstrated success in averting or reducing neurological damage in a majority of patients.
• No hemorrhagic complications were reported, indicating a favorable safety profile.