Problems of Superselective Thrombolytic Therapy in Acute Embolic Stroke

A series of 14 patients with cerebral embolism were treated by superselective thrombolytic therapy. Our criteria for candidates for this treatment are: 1) within five hours after onset and 2) no abnormal high or low density area on the CT scan. A high recanalization (93%) rate and neurological impro...

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Bibliographic Details
Published in:Nihon Kyukyu Igakukai Zasshi 1995/04/15, Vol.6(2), pp.146-154
Main Authors: Hirohata, Masaru, Kikuchi, Taisuke, Nakashima, Hironori, Miyagi, Jun, Shigemori, Minoru, Sakamoto, Teruo, Kaku, Nobuo
Format: Article
Language:English
Subjects:
cerebral embolism
local thrombolytic therapy
tissue plasminogen activator (t-PA)
urokinase
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Summary:A series of 14 patients with cerebral embolism were treated by superselective thrombolytic therapy. Our criteria for candidates for this treatment are: 1) within five hours after onset and 2) no abnormal high or low density area on the CT scan. A high recanalization (93%) rate and neurological improvement (57%) were achieved with either urokinase or tissue plasminogen activator (t-PA), but 3 patients had an unfavorable outcome due to hemorrhagic complications and reocclusion. All of these complications were related to poor collateral circulation and inadequate medical treatment after this therapy. Careful patient selection is necessary for distal occlusion of the MCA because of poorer clinical outcome than in proximal M1 occlusion.
ISSN:0915-924X
1883-3772
DOI:10.3893/jjaam.6.146