| Simple microwire and microcatheter mechanical thrombolysis with adjuvant intraarterial urokinase for treatment of hyperacute ischemic stroke patients. | |
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MedLine Citation:
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PMID: 18365826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mechanical thrombolysis may effectively enhance the efficacy of thrombolysis for hyperacute ischemic stroke patients. PURPOSE: To assess the feasibility and results of simple mechanical-based thrombolysis using microwire and microcatheter with adjuvant low-dose intraarterial (i.a.) urokinase (UK) for the treatment of hyperacute ischemic stroke. MATERIAL AND METHODS: Nineteen consecutive patients with hyperacute proximal middle cerebral artery (MCA) occlusions treated by a standardized protocol using microwire and microcatheter for mechanical thrombus disruption with adjuvant i.a. UK were reviewed. Simple to-and-fro passages through the clot with the microwire and microcatheter followed by disruptions by a J- or pigtail-shaped wire tip with alternating small-dose injections of UK distal, within, and proximal to the clot were performed. The recanalization rates, post-thrombolysis hemorrhage, and clinical outcome (baseline and discharge National Institute of Health Stroke Scale [NIHSS], mortality, 3-month modified Rankin scale [mRS]) were evaluated. RESULTS: Recanalization was achieved in 18 of 19 patients (94.7%). The mean UK dose was 375,789 IU (range 130,000-580,000 IU). Two patients (10.5%) developed symptomatic hemorrhage. One of the hemorrhages included a patient who developed subarachnoid hemorrhage. Mortality rate was 15.8% (n = 3). The median baseline NIHSS scores showed improvement from 17 to 10 at presentation and discharge, respectively. At three months, good outcome was noted in 11 of 19 patients (57.9%, mRS 0-2). CONCLUSION: Simple mechanical-based thrombolysis using microwire and microcatheter with adjuvant low-dose i.a. UK is safe and effective in achieving recanalization with good long-term outcome. |
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Authors:
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Dong Joon Kim; Dong Ik Kim; Joon Soo Byun; Jin Young Jung; Sang Hyun Suh; Eung Yeop Kim; Kyung-Yul Lee; Ji Hoe Heo |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta radiologica (Stockholm, Sweden : 1987) Volume: 49 ISSN: 1600-0455 ISO Abbreviation: Acta Radiol Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-27 Completed Date: 2008-04-22 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8706123 Medline TA: Acta Radiol Country: Sweden |
Other Details:
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Languages: eng Pagination: 351-7 Citation Subset: IM |
Affiliation:
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Department of Radiology, Yonsei University College of Medicine, Seoul, Korea. dikim@yumc.yonsei.ac.kr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Aged, 80 and over Catheterization / instrumentation* Chemotherapy, Adjuvant Combined Modality Therapy / adverse effects, instrumentation, methods Feasibility Studies Female Fibrinolytic Agents / administration & dosage, adverse effects, therapeutic use* Follow-Up Studies Humans Infarction, Middle Cerebral Artery / drug therapy* Injections, Intra-Arterial Male Middle Aged Prospective Studies Thrombolytic Therapy / adverse effects, instrumentation*, methods Treatment Outcome Urokinase-Type Plasminogen Activator / administration & dosage, adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
| Comments/Corrections | |
Comment In:
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Acta Radiol. 2008 Apr;49(3):249
[PMID:
18365806
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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