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Ten of the 21 patients (average age, 48 years) had a good outcome; three (average age, 71 years) had a poor outcome; eight patients (average age, 78 years) died. Partial/complete (successful) recanalization was observed in 11 of 26 patie nts and minimal or no (unsuccessful) recanalization in 15. Recanalization favored a better outcome: nine of 21 had successful recanalization, with a good outcome in seven; 12 of 21 had unsuccessful reperfusion, with poor outcome/death in nine. Poor outco me was noted in five patients with internal carotid artery (ICA) bifurcation occlusions, four of whom had unsuccessful recanalization and poor outcome or death. Hemorrhage occurred in 10 of the 26 patients, with clinical deterioration in three. The aver age dose of urokinase was higher in the hemorrhage group, and mortality was higher in patients who hemorrhaged. Intraarterial thrombolysis is feasible in the setting of acute stroke. Successful reperfusion is associated with a better outcome, and the pr evalence of hemorrhage does not exceed that which occurs in the natural history of embolic stroke. Poor outcome or death is associated with nonrecanalization, older age, hemorrhage, and ICA bifurcation occlusions. |
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angiography,cerebral
carotid artery occlusion,neck
cerebrovascular accident
cerebrovascular accident,acute management of
cerebrovascular accident,thrombolytic agents in treatment
cerebrovascular accident,volume
fibrinolytic agents
fibrinolytic agents,complications
fibrinolytic agents,intra-arterial local infusion
intracerebral hemorrhage
mortality
prognosis
recanalization,arterial
review article
treatment of neurologic disorder
urokinase
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