Abstract
An effect of local intraarterial fibrinolytic therapy with urokinase was evaluated in 15 patients with acute cerebral arterial occlusion (16 times). CT scans on admission demonstrated no low density lesions in all patients. Urokinase (UK) was infused nearly to the occlusion site through 3F Tracker-18 catheter 3.5-9.0 hours (mean 5.8 hours) after the onset of symptoms. The amount of UK ranged from 240, 000 to 1, 500, 000 units in each procedure. The sites of arterial occlusion were on the middle cerebral artery in 13 patients, on the basilar artery in 2 and on the internal carotid artery in one. Recanalization of the occluded arteries occurred immediately after the infusion on therapy in 12 of 16 procedures. Clinical symptoms recovered immediately after the infusion in 11 cases and gradually disappeared at the time of discharge in 7 cases. CT scans following the infusion therapy revealed hemorrhagic infarction in 3 patients who had received the therapy more than 6 hours after onset, but these lesions did not cause further deterioration of symptoms.
It has been suggested that superselective intraarterial UK infusion through 3F Tracker-18 catheter may be effective for patients with acute cerebral arterial occlusion, if the indication for the therapy is strictly, made.
