Abstract
Acute local intra-arteriral fibrinolysis (LIF) should be neutrally evaluated at present. The efficacy of LIF has never been evaluated objectively, and standard pre-therapeutic evaluation and therapeutic technique has never been established. Regarding to the efficacy, PROACT II was performed and finished in USA, but final decision is still postponed. MELT Japan is now progressing in Japan. The subject of both studies is middle cerebral artery embolism, so no such study is still performed for basilar artery embolism. Standard pretherapeutic evaluation and therapeutic technique are established in MELT Japan. The patient in whom LIF can be started within 6 hours after onset, with the NIH stroke scale of 5 to 22, without ischemic lesion in cerebral cortex can be enrolled in MELT Japan. Midterm results were reported in February 2004. The total cases registered were 68 and the cases finishing follow-up period of 3 months were 52. The cases with modified Rankin Scale (mRS) 0 to 2 at 3 months were 12 in 26 LIF group, while 8 in control group. The study period of MELT Japan was postponed and MELT Japan is still in progress now.
