| Thrombolytic therapy in acute occlusion of the intracranial internal carotid artery bifurcation. | |
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MedLine Citation:
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PMID: 8585483 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate efficacy and clinical benefit of early thrombolytic therapy in intracranial internal carotid artery occlusion. METHODS: Thirty-two patients (mean age, 56 years) with acute intracranial internal carotid artery occlusion were studied clinically and with CT and angiography before and after thrombolytic therapy with intravenous alteplase (n = 16), superselective intraarterial alteplase (n = 8), and superselective intraarterial urokinase (n = 8). RESULTS: Initial CT showed a large parenchymal hypodensity in 11 (34%) patients, a small hypodensity in 15 (47%) patients, and no hypodensity in 6 (19%) patients. Recanalization after thrombolytic therapy was observed in 4 patients (12.5% in each treatment group). Follow-up CT showed six hemorrhagic infarcts and four parenchymal hematomas unrelated to recanalization, alteplase, or urokinase administration, but commonly associated with intraarterial treatment. Clinical outcome was fatal in 53%, poor in 31%, and moderate or good in 16% of the patients. Outcome was equal in different treatment groups and closely linked to both the quality of leptomeningeal collaterals and the extent of parenchymal hypodensity on the first CT. CONCLUSION: Because intravenous or intraarterial treatment with alteplase or urokinase fails to recanalize the vascular obstruction, it does not improve the prognosis of intracranial internal carotid artery occlusion over that of the natural course. Improved results may be possible with novel recanalization techniques. |
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Authors:
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O Jansen; R von Kummer; M Forsting; W Hacke; K Sartor |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 16 ISSN: 0195-6108 ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 1995 Nov-Dec |
Date Detail:
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Created Date: 1996-03-21 Completed Date: 1996-03-21 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: 1977-86 Citation Subset: IM |
Affiliation:
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Department of Neuroradiology, University of Heidelberg, School of Medicine, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Brain Ischemia / drug therapy, mortality, radiography Carotid Artery Thrombosis / drug therapy*, mortality, radiography Carotid Artery, Internal / drug effects, radiography Cerebral Infarction / drug therapy, mortality, radiography Collateral Circulation / drug effects, physiology Dose-Response Relationship, Drug Drug Administration Schedule Female Fibrinolytic Agents / adverse effects, therapeutic use* Humans Intracranial Embolism and Thrombosis / drug therapy*, mortality, radiography Male Meninges / blood supply Middle Aged Survival Rate Thrombolytic Therapy* Tissue Plasminogen Activator / adverse effects, therapeutic use* Treatment Outcome Urokinase-Type Plasminogen Activator / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
| Comments/Corrections | |
Comment In:
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AJNR Am J Neuroradiol. 1995 Nov-Dec;16(10):1994-2000
[PMID:
8585485
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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