Faculty Collaboration Database

Selective thrombolysis of central retinal artery occlusion without long-term systemic heparinization. Surg Neurol 1998 Nov;50(5):408-10

Date

12/08/1998

Pubmed ID

9842863

DOI

10.1016/s0090-3019(97)00338-8

Scopus ID

2-s2.0-0032212264 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

BACKGROUND: A central retinal artery occlusion is a potentially blinding retinal vascular event with no effective treatment regimen available. Recently, a few reports have described improved vision in eyes with central retinal artery occlusions after selective fibrinolytic therapy followed by long-term systemic anticoagulation. Acceptance of this treatment, however, has been hampered by a paucity of confirmatory reports and its potential for producing serious hemorrhagic complications. Our report independently confirms the beneficial effects of selective thrombolysis, even with the use of only short-term, post-procedure systemic heparinization.

METHODS: A case report of selective fibrinolysis of an occluded central retinal artery using urokinase infusion into the ophthalmic artery followed with only 12 h of systemic heparinization is described.

RESULTS: A 65-year-old man presenting with a central retinal artery occlusion of less than 4-h duration enjoyed an improvement of vision from counting-fingers acuity to 20/20 after selective fibrinolysis with urokinase and only 12 h of systemic heparinization. No hemorrhagic or thrombotic complications occurred.

CONCLUSIONS: Selective thrombolysis with urokinase followed by short-term systemic heparinization can effectively treat a central retinal artery occlusion. Whereas the authors acknowledge that a single case does not prove that short-term heparinization is better than long-term heparinization, it does show that the latter is not always required.

Author List

Wirostko WJ, Pulido JS, Hendrix LE

Author

William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

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

Aged
Angiography
Fibrinolytic Agents
Heparin
Humans
Infusions, Intra-Arterial
Male
Ophthalmic Artery
Retinal Artery Occlusion
Thrombolytic Therapy
Time Factors
Treatment Outcome
Urokinase-Type Plasminogen Activator