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Evaluation of Risk of Hemorrhagic Transformation in Local Intra-arterial Thrombolysis in Acute Ischemic Stroke by Initial SPECT Stroke 25:298-303, Ueda,T.,et al, 1994 See this aricle in Pubmed Article Abstract The occluded vessels could be recanalized in 22(92%)of the 24 patients in the urokinase group and in all 10 of the patients in the rt-PA group. Hemorrhagic transformation appeared in 4 patients in the urokinase group and 3 patients in the rt-PA group.Among the 20 patients who underwent SPECT before the treatment,the residual CBF was lower in the 5 patients who developed hemorrhagic transformation than in the 15 who did not(P<. 05).Hemorrhagic transformation occurred in all patients with R/CE ratio of less than 0.35 and AI of more than 1.5.The risk of hemorrhage transformation after recanalization of occluded vessels by local intra- arterial thrombolytic therapy was considered to be high when the pretherapeutic residual CBF was markedly reduced.

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