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Neuroradiology

, Volume 35, Issue 2, pp 159–162 | Cite as

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

  • H. Zeumer
  • H. -J. Freitag
  • F. Zanella
  • A. Thie
  • C. Arning
Interventional Neuroradiology

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.

Key words

Fibrinolysis Urokinase Recombinant tissue plasminogen activator Thromboembolic stroke 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • H. Zeumer
    • 1
  • H. -J. Freitag
    • 1
  • F. Zanella
    • 1
  • A. Thie
    • 2
  • C. Arning
    • 3
  1. 1.Department of NeuroradiologyUniversity Hospital EppendorfHamburgFederal Republic of Germany
  2. 2.Department of NeurologyUniversity Hospital EppendorfHamburgFederal Republic of Germany
  3. 3.Department of NeurologyAllgemeines Krankenhaus BarmbekHamburgFederal Republic of Germany

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