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

Neuroradiology. 1993;35(2):159-62. doi: 10.1007/BF00593977.


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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carotid Artery Thrombosis / drug therapy
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / drug therapy*
  • Cerebrovascular Disorders / etiology
  • Humans
  • Intracranial Embolism and Thrombosis / drug therapy
  • Radiography, Interventional
  • Thrombolytic Therapy* / adverse effects
  • Thrombolytic Therapy* / methods
  • Urokinase-Type Plasminogen Activator / therapeutic use*
  • Vertebrobasilar Insufficiency / drug therapy


  • Urokinase-Type Plasminogen Activator