Thrombolytic therapy of cerebral arterial occlusion with recombinant tissue plasminogen activator

Neurol Res. 1990 Jun;12(2):78-80. doi: 10.1080/01616412.1990.11739920.

Abstract

This report describes three patients, with acute cerebral arterial occlusion, treated with recombinant tissue plasminogen activator (rt-PA). In one patient with basilar artery occlusion thrombolytic treatment was initiated 12 h after onset of the symptoms. In two patients with angiographically verified occlusion of the middle cerebral artery, the treatment was initiated approximately 4.5 h after onset of the symptoms. Recombinant tissue plasminogen activator 80-120 mg, was infused intra-arterially over 90-100 min via a catheter the tip of which was close to the occlusion. This regimen resulted in recanalization in all the patients; however, in two patients it was verified by repeat CT scan only. In two patients the thrombolytic treatment was successful (the patients improved clinically); the third patient died of massive cerebral infarct-related oedema. In none of the patients did significant bleeding or other obvious side-effects occur. From this preliminary report it is concluded that angiographically proven thrombolytic recanalization in acute cerebrovascular occlusion is possible with rt-PA. In some patients, however, the treatment is initiated too late. Further investigation of the possible indication for thrombolytic therapy in stroke is needed.

MeSH terms

  • Adult
  • Aged
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / drug therapy*
  • Cerebral Arterial Diseases / diagnostic imaging
  • Cerebral Arterial Diseases / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recombinant Proteins / therapeutic use*
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / therapeutic use*
  • Tomography, X-Ray Computed

Substances

  • Recombinant Proteins
  • Tissue Plasminogen Activator