Thrombolytic Therapy of Basilar Artery Occlusion: Preconditions for Recanalization and Good Clinical Outcome
Although at times an incidental finding in asymptomatic patients [1–3], occlusion of the basilar artery (BA) with progressive brainstem symptoms has a poor prognosis: mortality is between 60% and 100% [4–6]. The first successful and angiographically proved recanalization of the BA with urokinase (u-PA) in a young female patient after 4 days of severe brainstem symptoms and consecutive excellent clinical outcome  has encouraged others to develop the technique of intraarterial (IA) fibrinolytic therapy in patients with acute vertebrobasilar occlusion . On the basis of anecdotal reports and small uncontrolled studies, the experience with thrombolysis in vertebrobasilar stroke has established two convictions: (1) administration of fibrinolytics such as streptokinase, u-PA, and recombinant tissue plasminogen activator (rt-PA) can recanalize occluded intracranial arteries, and (2) recanalization of the basilar artery is safe, clinically beneficial, and lifesaving in selected cases.
KeywordsAcute Ischemic Stroke Thrombolytic Therapy Basilar Artery Barthel Index Fibrinolytic Therapy
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