Macleod M R, Davis S M, Mitchell P J, Gerraty R P, Fitt G, Hankey G J, Stewart-Wynne E G, Rosen D, McNeil J J, Bladin C F, Chambers B R, Herkes G K, Young D, Donnan G A
National Stroke Research Institute, Melbourne, Australia.
Cerebrovasc Dis. 2005;20(1):12-7. doi: 10.1159/000086121. Epub 2005 May 30.
Patients with ischaemic stroke due to occlusion of the basilar or vertebral arteries may develop a rapid deterioration in neurological status leading to coma and often to death. While intra-arterial thrombolysis may be used in this context, no randomised controlled data exist to support its safety or efficacy.
Randomised controlled trial of intra-arterial urokinase within 24 h of symptom onset in patients with stroke and angiographic evidence of posterior circulation vascular occlusion.
Sixteen patients were randomised, and there was some imbalance between groups, with more severe strokes occurring in the treatment arm. A good outcome was observed in 4 of 8 patients who received intra-arterial urokinase compared with 1 of 8 patients in the control group.
These results support the need for a large-scale study to establish the efficacy of intra-arterial thrombolysis for acute basilar artery occlusion.
因基底动脉或椎动脉闭塞导致缺血性卒中的患者，神经功能状态可能迅速恶化，进而发展为昏迷，甚至常常导致死亡。虽然在此情况下可采用动脉内溶栓治疗，但尚无随机对照数据支持其安全性或有效性。
对症状发作24小时内、有血管造影证据显示后循环血管闭塞的卒中患者进行动脉内尿激酶随机对照试验。
16例患者被随机分组，两组之间存在一些不均衡情况，治疗组中发生的卒中更为严重。接受动脉内尿激酶治疗的8例患者中有4例预后良好，而对照组的8例患者中只有1例预后良好。
这些结果表明有必要开展大规模研究，以确定动脉内溶栓治疗急性基底动脉闭塞的疗效。
