Document Detail


Balloon catheter disruption of middle cerebral artery thrombus in conjunction with thrombolysis for the treatment of acute middle cerebral artery embolism.
MedLine Citation:
PMID:  17353326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The goal of this study was to prospectively assess the feasibility, safety, and efficacy of balloon disruption of the middle cerebral artery (MCA) by using a deflated balloon catheter combined with an intra-arterial thrombolysis for the treatment of acute ischemic stroke. MATERIALS AND METHODS: Seven consecutive patients with clinical findings of acute major-vessel stroke met our criteria and underwent balloon disruption of an MCA thrombus with a deflated balloon catheter. The balloon disruption was performed with a low-profile microballoon catheter. The microballoon was inflated in the distal carotid artery and then deflated and advanced just distal to the occlusion site in the MCA. Thereafter, an intra-arterial thrombolysis of the MCA was applied. The maximum time from the onset of symptoms to the start of treatment and maximum dosage of urokinase was 6 hours and 600,000 U. The outcome was classified as good for a modified Rankin Scale (mRS) score of 0 or 1, moderate for a score of 2 or 3, and poor for a score of 4 or 5. RESULTS: Complete recanalization was achieved in 5 patients and partial recanalization in 3. Three patients recovered to an mRS score of 0 or 1; 3, to scores of 2 or 3; and 1, to a score of 4. No patients died. There was no major intracerebral hemorrhage. CONCLUSIONS: The penetration of the MCA with a deflated balloon catheter combined with an intra-arterial thrombolysis may be a safe and effective treatment for acute ischemic stroke.
Authors:
I Ikushima; H Ohta; T Hirai; K Yokogami; D Miyahara; N Maeda; Y Yamashita
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  28     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-04-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  513-7     Citation Subset:  IM    
Affiliation:
Department of Radiology, Miyakonojo Medical Association Hospital, Miyakonojo, Japan. iku-i@fk.enjoy.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angioplasty, Balloon*
Cerebral Angiography
Combined Modality Therapy
Female
Fibrinolytic Agents / administration & dosage*
Humans
Infarction, Middle Cerebral Artery / drug therapy*,  radiography
Male
Middle Aged
Pilot Projects
Retrospective Studies
Thrombolytic Therapy*
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

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