| Safety and efficacy of delayed intraarterial urokinase therapy with mechanical clot disruption for thromboembolic stroke. | |
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MedLine Citation:
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PMID: 7863929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate safety and efficacy of delayed intraarterial urokinase therapy with mechanical disruption of clot to treat thromboembolic stroke. METHODS: Thirteen patients with cerebral thrombolic disease (10 carotid territory, 3 basilar territory) were treated with catheter-directed intraarterial urokinase therapy with mechanical disruption of the clots. All patients were excluded from a 6-hour multicenter thrombolytic trial by either time, recent surgery, age, seizure, or myocardial infarction. Time elapsed before treatment ranged from 3.5 to 48 hours (12 +/- 13 hours), with 200,000 to 900,000 U of urokinase used. RESULTS: Ten patients had successful vessel recanalization, confirmed by repeat angiography. Cases with distal branch vessel occlusions were less likely to recanalize. Asymptomatic hemorrhagic conversion occurred in 2 patients on repeat scans. Both acute neurologic and functional outcomes were assessed with significant improvement occurring in 9 (69%) of 13 patients at 48 hours (greater than four-point change on the National Institutes of Health scale) and in 100% of 3-month survivors. All patients who improved had normal initial CT scans. CONCLUSIONS: Intraarterial cerebral thrombolysis with mechanical disruption of clot seems to be a useful therapy in selected stroke cases even after 6 hours. |
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Authors:
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S L Barnwell; W M Clark; T T Nguyen; O R O'Neill; M L Wynn; B M Coull |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 15 ISSN: 0195-6108 ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 1994 Nov |
Date Detail:
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Created Date: 1995-03-17 Completed Date: 1995-03-17 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1817-22 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Oregon Health Sciences University, Portland 97201. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Angioplasty, Balloon* Cerebral Angiography Child Combined Modality Therapy Dose-Response Relationship, Drug Drug Administration Schedule Female Follow-Up Studies Humans Infusions, Intra-Arterial Intracranial Embolism and Thrombosis / drug therapy*, radiography Male Middle Aged Neurologic Examination / drug effects Thrombolytic Therapy / methods* Tomography, X-Ray Computed Treatment Outcome Urokinase-Type Plasminogen Activator / administration & dosage*, adverse effects |
| 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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