Stroke, Vol 19, 307-313, Copyright © 1988 by American Heart Association
GJ del Zoppo, A Ferbert, S Otis, H Bruckmann, W Hacke, J Zyroff, LA Harker and H Zeumer
The possibility that intra-arterial local infusion of fibrinolytic agents
may achieve recanalization of previously occluded carotid territory
arteries in acute stroke was tested in a prospective angiography-based open
pilot study at two centers. Fifteen of 20 patients with acute symptoms
(mean treatment-onset interval 7.6 hours) demonstrated complete
recanalization; 10 of the 15 patients exhibited clinical improvement of
varying degree by the time of hospital discharge. Four of the 20 patients
suffered hemorrhagic transformation of the infarcted territory without
clinical deterioration or demise. Because of the study format and the
limited number of patients, dose responses for recanalization and risk
relations were not established. We conclude that local intra-arterial
fibrinolytic therapy may lead to cerebral arterial recanalization in acute
carotid territory thrombotic stroke. The particular implications and
limitations of this approach are discussed.
ARTICLES
Local intra-arterial fibrinolytic therapy in acute carotid territory stroke. A pilot study
Abteilung Neurologie Klinikum, Rheinisch-Westfalische Technische Hochschule, Aachen, Federal Republic of Germany.
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|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
 J. F. Rothrock and R. G. Hart Antithrombotic Therapy in Cerebrovascular Disease Ann Intern Med, December 1, 1991; 115(11): 885 - 895. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
R. J. Frink and L. H. Ostrach Streptokinase in the Treatment of an Acute Cerebral Embolus A Case Report Angiology, January 1, 1990; 41(1): 66 - 69. [Abstract] [PDF]
|
|