Intra-arterial Thrombolytic Therapy in Acute Ischemic Stroke a Preliminary Study

J Korean Neurol Assoc > Volume 8(1); 1990 > Article

Journal of the Korean Neurological Association 1990;8(1): 1-13.

급성 허혈성 뇌졸중 환자에 있어서 응급 관동맥내 혈전용해제 주입요법에 관한 예비 연구

이병인, 이병철,김진수,김동익,정태섭,서정호

연세대학교 신경과, 방사선과.

Intra-arterial Thrombolytic Therapy in Acute Ischemic Stroke a Preliminary Study

Byung In Lee, M.D., Byung Chul Lee, M.D., Jin Soo Kim, M.D., Dong Ik Kim, M.D., Tae Sub Chung M.D., Jung Ho Suh, M.D.,

Department of Neurology and Radiology, Yonsei University College of Medicine

Abstract

:We conducted a pilot study to evaluate the possibility that the intra-arterial thrombolybolytic therapy might lead to recanalization of the acutely occluded cerebral arteries and subsequent clinical improvement in patients with acute ischemic stroke. Mean time from the onset of symptoms to the start of treatment and mean dosage of thrombolytic agent, Urokinase, were 6.4 hours and 120.3x104 units respectively. Seven of 12 cases with acute ischemic stroke demonstrated successful recanalization: 5 cases achieved complete recanalization; 2 cases partial recanalization, and remaining 5 cases did not show any evidence of recanalization. Neurological evaluation at 1 week and 3 months after the onset of symptoms suggested better outcome in a cases with recanalization. Repeat CT scan at 24 hours and 1 week after the procedure demonstrated evidence of hemorrhagic transformation in the infarcted territories in 5 cases(all in recanalized group), but clinical de teriorations were observed in only 2 case. Though statistical analysis could not be done because of the limited number of cases, these results suggest that the intra-arterial thrombolytic therapy had a role in the management of acute major carebral ischemic stroke.