Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA) (original) (raw)

Summary

A group of 59 patients with stroke due to acute vertebrobasilar or carotid territory occlusion have been treated by local intra-arterial fibrinolysis (LIF). A high recanalisation rate was accomplished with either urokinase or recombinant tissue plasminogen activator (r-TPA). However, with either substance, even if a high dose was used, recanalisation was a time-consuming process which usually took 120 min. A reasonable explanation for the lack of effectiveness of these plasminogen-activating substances might be a deficit of substrate, e.g. plasminogen, in aged thrombus. LIF was capable of improving clinical outcome in acute vertebrobasilar artery occlusion, reducing mortality to 50% in patients fulfilling inclusion criteria. In the carotid territory multiple occlusions had a poor prognosis while good clinical results could be achieved in occlusions of the proximal middle cerebral artery or single branches.

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Authors and Affiliations

  1. Department of Neuroradiology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany
    H. Zeumer, H. -J. Freitag & F. Zanella
  2. Department of Neurology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany
    A. Thie
  3. Department of Neurology, Allgemeines Krankenhaus Barmbek, Hamburg, Federal Republic of Germany
    C. Arning

Authors

  1. H. Zeumer
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  2. H. -J. Freitag
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  3. F. Zanella
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  4. A. Thie
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  5. C. Arning
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Zeumer, H., Freitag, H.J., Zanella, F. et al. Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA).Neuroradiology 35, 159–162 (1993). https://doi.org/10.1007/BF00593977

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