Abstract
Background and Purpose: Acute occlusion of the vertebrobasilar artery is often diagnosed more than 6 hours after onset in clinical practice. The indications for thrombolysis in such cases are not well understood. Patients and Methods: A total of 19 cases with vertebrobasilar occlusion were treated. Intraarterial thrombolysis with urokinase was performed in 13 cases, urokinase with percutaneous transluminal angioplasty (PTA) in 4, and intravenous TPA in 2. Twelve cases were treated within 6 hours of onset, whereas 7 cases were treated 6 hours or more after onset. The treatment results in these two groups were compared using the modified Rankin scale (MRS) at 3 months. Results: Thrombolytic therapy within 6 hours yielded excellent outcomes, with 6 out of the 12 patients showing an mRS of below 2. However, in patients treated aftre 6 hours or more, only 2 out of the 7 patiens demonstrated an excellent result with mRS below 2. Conclusion: The findings obtained indicated that the treatment results were favorable in patients treated within 6 hours of onset, but in patients treated 6 hours or more after the onset of occlusion, a favorable outcome could only be expected when the initial INHSS was not severe.
