Acute stroke intervention with intraarterial urokinase infusion

J Vasc Interv Radiol. Sep-Oct 1994;5(5):705-13. doi: 10.1016/s1051-0443(94)71588-8.

Abstract

Purpose: A preliminary evaluation of the efficacy and safety of treating patients with acute stroke with intraarterial urokinase infusions was performed.

Patients and methods: Twelve patients with acute stroke were treated within 8 hours of symptom onset (average, 5 hours). Thrombolysis was performed within the middle cerebral (n = 10), internal carotid (n = 1), and basilar (n = 1) arteries. Urokinase (160,000-500,000 IU) was infused through microcatheters placed into or adjacent to the thrombi.

Results: Thrombolysis was angiographically successful in nine patients (75%), all of whom had long-term neurologic improvement. No or minimal neurologic deficits were present in six patients (50%). Thrombolysis failed in three patients (25%); one patient died and two developed severe permanent neurologic deficits. No hemorrhagic complications occurred.

Conclusion: Preliminary results suggest that intraarterial urokinase infusion may be effective and safe for treating patients with acute stroke. Potentially devastating neurologic damage was averted or lessened in nine patients (75%). No additional neurologic damage was caused by intervention in the remaining three patients (25%).

Publication types

  • Clinical Trial

MeSH terms

  • Cerebral Angiography
  • Cerebral Arteries
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / drug therapy*
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Male
  • Middle Aged
  • Nervous System Diseases / prevention & control
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Urokinase-Type Plasminogen Activator / therapeutic use*

Substances

  • Urokinase-Type Plasminogen Activator