Document Detail


Local intra-arterial fibrinolysis in thromboembolic "T" occlusions of the internal carotid artery.
MedLine Citation:
PMID:  9045970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Local intra-arterial fibrinolysis (LIF) is considered to support spontaneous recanalisation, which does not usually occur fast enough to prevent an infarct. Therefore, LIF may, at least theoretically, be especially useful in occlusions with large thromboembolic masses. We report our experience of LIF with urokinase in 12 patients with combined occlusions of the distal internal carotid, anterior and middle cerebral arteries (carotid "T" occlusions). There were 4 patients who survived with minor neurological deficits (Barthel index > 90), 4 with major deficits (Barthel index 40-55) and 4 patients died: in one of the last group a haematoma developed in a middle cerebral artery infarct. Recanalisation and clinical outcome were parallel in 10 of 12 patients. A patient with excellent leptomeningeal collaterals had a good clinical outcome despite only moderate recanalisation, and the patient with the parenchymal haematoma had good recanalisation. Recanalisation with urokinase in carotid "T" occlusions is often poor, but outcome can be good if treatment starts early, recanalisation succeeds and leptomeningeal collateral supply is good. Our results therefore encourage us, unlike previously reported series, to perform LIF in this type of occlusion.
Authors:
H Urbach; F Ries; B Ostertun; L Solymosi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neuroradiology     Volume:  39     ISSN:  0028-3940     ISO Abbreviation:  Neuroradiology     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-06-03     Completed Date:  1997-06-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, University of Würzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain / blood supply
Carotid Artery Thrombosis / radiography,  therapy*
Cerebral Angiography
Cerebral Infarction / radiography,  therapy*
Collateral Circulation / physiology
Female
Humans
Male
Meninges / blood supply
Middle Aged
Regional Blood Flow / physiology
Thrombolytic Therapy*
Tomography, X-Ray Computed
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage*
Chemical
Reg. No./Substance:
EC 3.4.21.73/Urokinase-Type Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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