Local intra-arterial fibrinolysis in vertebrobasilar artery occlusion: urokinase versus recombinant tissue plasminogen activator
From 1987 to 1994 local intra-arterial fibrinolysis was performed in 49 patients with occlusion of the vertebrobasilar system. Urokinase (13 patients) and high-dose recombinant tissue plasminogen activator (rTPA) (36 patients) was used in 25 patients semiselectively and in 24 patients with microcatheters at the thrombus side. Of all patients, 53% survived, 65% of them with good outcome. rTPA showed a better recanalisation rate than urokinase, when a microcatheter was used (81%). The superselective microcatheter procedure was superior to the proximal vertebral catheter treatment. The best results were obtained if the preceding coma lasted not longer than 3 h; of these 27 patients 63% survived, 76% of them with only minor deficits.
Key wordsFibrinolysis Vertebrobasilar system
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