“Central” Intraarterial Thrombolysis Using a Newly Developed Low Friction Guidewire/Catheter System

  • K. Goto
  • N. Ogata


Fibrinolytic therapy for cerebral embolism was initially accomplished by intravenous administration of urokinase and streptokinase. Although this was technically easy, results were far from satisfactory; no significant change was seen in treated patients compared with the control group, and mortality rate was high among the treated group [1]. Therefore, this method was abandoned. In recent years, clinical trials in treating patients with cerebral embolism by intravenous administration of a new fibrinolytic agent recom­binant tissue plasminogen activator (rt-PA), which has a strong affinity to fibrin in the embolus, have been done. This was said to be effective compared to the control group, but the reported recanalization rate, which was 30%–50%, was not yet satisfactory [2,3]. Furthermore, this seems to be more effective for small emboli lodging in the cortical branches than large emboli lodging in the more proximal arteries.


Cerebral Artery Fibrinolytic Therapy Cerebral Embolism Fibrinolytic Agent Intraarterial Thrombolysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fletcher AP, Alkaersig N, Lewis M, Tulevski V, Davis A, Brooks JE, Hardin WB, Landau WM, Raichle ME (1976) A pilot study of urokinase therapy in cerebral infarction. Stroke 7: 135–142PubMedCrossRefGoogle Scholar
  2. 2.
    Mori E, Yoneda Y, Tabuchi M, Yoshida T, Ohkawa S, Ohsumi Y, Kitano K, Tsutsumi A, Yamadori A (1992) Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 42: 976–982PubMedGoogle Scholar
  3. 3.
    rt-PA Acute Stroke Study Group (1991) An open safety/efficacy trial of rt-PA in acute thromboembolic stroke; final report (abstr). Stroke 22: 153Google Scholar
  4. 4.
    Mori E, Tabuchi M, Yoshida T, Yamadori A (1988) Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 19: 802–812PubMedCrossRefGoogle Scholar
  5. 5.
    Yabumoto M, Ryujin K, Imae S, Yoshida N, Yukawa S, Kamei I, Iwamoto M, Kuriyama T (1991) Intraarterial injection of low molecular weight dextran and urokinase for acute cerebral infarction. Neurol Surg (Tokyo) 19: 723–728Google Scholar
  6. 6.
    del Zoppo GJ, Ferbert A, Otis S, Bruckmann H, Hacke W, Zyroff J, Harker LA, Zeumer H (1988) Local intra-arterial fibrinolytic therapy in acute carotid territory stroke; a pilot study. Stroke 19: 307–313PubMedCrossRefGoogle Scholar
  7. 7.
    Sugawara Y, Ueda T, Mogami H, Tanada S, Hamamoto K (1992) Intraarterial urokinase infusion therapy with superselective catheterization for acute occlusive cerebrovascular disease. Nippon Act Radiol 52: 1083–1091Google Scholar
  8. 8.
    Goto K (1991) Low-friction high-torque guidewire: a new way for superselective catheterization. Neuroradiology 33 (suppl): 636–637Google Scholar
  9. 9.
    Goto K, Ogata N (1994) Interventional neuroradiological procedures using newly developed minimal friction guide wire/catheter system. Video J Jpn Neurosurg 2: 1Google Scholar
  10. 10.
    Zeumer H, Freitag H-J, Knospe V (1992) Intravascular thrombolysis in central nervous system cerebrovascular disease. Neuroimaging Clin North Am 2: 359–368Google Scholar
  11. 11.
    Mitsuyama Y, Thompson LR, Hayashi T (1979) Autopsy study of cerebrovascular disease in Japanese men who lived in Hiroshima, Japan, and Honolulu, Hawaii. Stroke 10: 389–395Google Scholar

Copyright information

© Springer-Verlag Tokyo 1995

Authors and Affiliations

  • K. Goto
    • 1
  • N. Ogata
    • 1
  1. 1.Interventional NeuroradiologyIizuka HospitalIizuka, 820Japan

Personalised recommendations