Faculty Collaboration Database

Intrathrombus administration of tissue plasminogen activator in acute cerebrovascular occlusion. Angiology 1995 Aug;46(8):649-56

Date

08/01/1995

Pubmed ID

7639410

DOI

10.1177/000331979504600802

Scopus ID

2-s2.0-0029045788 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

Intraarterial thrombolysis for acute cerebrovascular occlusion has achieved recanalization at a 50-90% rate. Clinical outcome has been unpredictable. The authors sought to test the hypothesis that intrathrombus administration of recombinant tissue plasminogen activator (rt-PA) would improve recanalization rate and to assess the possibility that clinical outcome would be predicted by the extent of collateral flow. Seven patients with acute cerebrovascular occlusion (less than six hours in 6, twenty-four hours in 1) were treated with intrathrombus rt-PA at 1 mg/minute. Examinations were scored on a five-point motor scale. Collateral flow was assessed angiographically. Vessels recanalized in 5 patients, 3 of whom had good outcomes. Vessels failed to recanalize in 2 patients, 1 of whom had good outcome. Good collateral flow was evident in all 4 patients with good outcome and in none of those with poor outcome. Intrathrombus administration of rt-PA is technically feasible. Favorable clinical outcome is more likely in the presence of good collateral flow. In the absence of good collateral flow, ultra-early intervention may be necessary.

Author List

Frey JL, Greene KA, Khayata MH, Dean BL, Hodak JA, Spetzler RF

Author

Karl A. Greene MD Adjunct Assistant Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Aged
Cerebral Angiography
Child, Preschool
Collateral Circulation
Female
Humans
Intracranial Embolism and Thrombosis
Male
Reperfusion
Tissue Plasminogen Activator
Tomography, X-Ray Computed