Abstract
Objective: The purpose of this study was to clarify efficacy and safety of a combined therapy of intravenous administration of recombinant tissue plasminogen activator (IV rt-PA) followed by an intra-arterial thrombolysis for acute embolic occlusion of cerebral major arteries.
Methods: From January 2008 to March 2010, 27 patients with acute major artery embolic occlusion underwent IV rt-PA, and nine patients, in whom recanalization of the affected arteries was not achieved using IV rt-PA, underwent the combined therapy of IV rt-PA and intra-arterial thrombolysis.
Results: Of the 27 patients treated with IV rt-PA, four patients (15%) showed favorable clinical outcomes 3 months after the treatment. On the other hand, in five of the nine patients treated with the combined therapy (55%), both successful recanalization immediately after the treatment and favorable outcomes at 3 months were obtained. No permanent deficits caused by the combined therapy were observed in the present series.
Conclusion: The combined therapy of IV rt-PA followed by intra-arterial thrombolysis is effective and safe for patients in whom recanalization of the occluded arteries is not achieved immediately after IV rt-PA therapy.
