Neuroradiology

, Volume 35, Issue 2, pp 159–162

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

DOI: 10.1007/BF00593977

Cite this article as:
Zeumer, H., Freitag, H.J., Zanella, F. et al. Neuroradiology (1993) 35: 159. doi:10.1007/BF00593977

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 

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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