| Local intra-arterial fibrinolysis in thromboembolic "T" occlusions of the internal carotid artery. | |
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MedLine Citation:
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PMID: 9045970 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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H Urbach; F Ries; B Ostertun; L Solymosi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neuroradiology Volume: 39 ISSN: 0028-3940 ISO Abbreviation: Neuroradiology Publication Date: 1997 Feb |
Date Detail:
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Created Date: 1997-06-03 Completed Date: 1997-06-03 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 1302751 Medline TA: Neuroradiology Country: GERMANY |
Other Details:
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Languages: eng Pagination: 105-10 Citation Subset: IM |
Affiliation:
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Department of Neuroradiology, University of Würzburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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