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Local Intra-arterial Fibrinolysis in the Vertebrobasilar and Carotid Territories

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Interventional Neuroradiology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Thromboembolic occlusion of the large pial vessels is a major cause of cerebral ischemic stroke. Recanalization of such occluded vessels seems to be the most reasonable therapeutic strategy in stroke patients. However, after the introduction of streptokinase as an effective fibrinolytic agent in the 1960s, early trials to ascertain its efficacy in stroke-prone patients failed to demonstrate a reasonable benefit to risk ratio (Del Zoppo et al. 1986). On the other hand, local fibrinolysis with the aim of coronary artery re-canalization proved effective in providing high recanalization rates with less systemic hemorrhagic effects. In the cerebral arteries local intra-arterial fibrinolytic (LIF) therapy has been applied primarily in those patients commonly displaying progression of stroke, usually with a lethal outcome, e.g., patients with acute vertebrobasilar occlusion (AVBO). The prognosis of patients suffering from AVBO was shown by Hacke et al. (1988) to be improved significantly using this treatment.

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Authors and Affiliations

  1. Abteilung für Neuroradiologie, Radiologische Klinik, Universitätskrankenhaus Eppendorf, Universität Hamburg, Martinistraße 52, W-2000, Hamburg 20, Germany

    Hermann Zeumer M.D. (Professor) & F. Zanella M.D. (Professor)

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  1. Hermann Zeumer M.D.
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  2. F. Zanella M.D.
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Editors and Affiliations

  1. Abteilung für Neuroradiologie Departement Medizinische Radiologie, Universitätsspital Zürich, Frauenklinikstrasse 10, 8091, Zürich, Switzerland

    Anton Valavanis M. D. (Professor) (Professor)

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© 1993 Springer-Verlag Berlin Heidelberg

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Zeumer, H., Zanella, F. (1993). Local Intra-arterial Fibrinolysis in the Vertebrobasilar and Carotid Territories. In: Valavanis, A. (eds) Interventional Neuroradiology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84434-8_11

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  • DOI: https://doi.org/10.1007/978-3-642-84434-8_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84436-2

  • Online ISBN: 978-3-642-84434-8

  • eBook Packages: Springer Book Archive

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