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Related Experiment Videos

Thrombolytic therapy in acute stroke

R T Higashida1, V V Halbach, S L Barnwell

  • 1Department of Radiology, University of California, San Francisco Medical Center 94143-0628, USA.

Journal of Endovascular Surgery : the Official Journal of the International Society for Endovascular Surgery
|September 1, 1994
PubMed
Summary

Local fibrinolysis effectively treated acute intracranial artery and dural sinus occlusions, improving neurological function in many stroke patients. This direct thrombolysis approach shows promise for reducing morbidity and mortality.

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Area of Science:

  • Neurology
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Acute occlusions of intracranial arteries and dural sinuses cause progressive neurological deterioration.
  • Systemic anticoagulation and antiplatelet therapies are often insufficient for these critical conditions.

Purpose of the Study:

  • To evaluate the safety and efficacy of direct intra-arterial and intravenous fibrinolysis.
  • To assess this treatment for acute intracranial cerebral artery and dural sinus occlusions.

Main Methods:

  • Selected patients with acute neurological decline underwent transfemoral catheterization.
  • A microcatheter was advanced into the thrombus for direct urokinase infusion.
  • Treatment continued until clot lysis was achieved.

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Main Results:

  • Neurological improvement occurred in 66.7% of 27 arterial occlusion cases.
  • Intracranial hemorrhage occurred in 11.1% of arterial cases.
  • In dural sinus thrombosis, 77.8% showed clot lysis and clinical improvement with local urokinase.

Conclusions:

  • Direct intra-arterial or intravenous fibrinolysis may improve outcomes for acute central nervous system thromboembolic disease.
  • This therapy holds potential for reducing stroke-related morbidity and mortality.
  • Further clinical studies are necessary to validate this treatment approach.