Chehrazi B B, Seibert J A, Kissel P, Hein L, Brock J M
Department of Neurological Surgery, University of California, Davis.
Neurosurgery. 1989 Mar;24(3):355-60. doi: 10.1227/00006123-198903000-00008.
In an effort to determine the value of tissue-type plasminogen activator (TPA) in the treatment of embolic stroke, 17 rabbits were subjected to a model of embolic stroke in which 2-hour-old, tin-impregnated, autologous clots were embolized to the bifurcation of the internal carotid artery at the circle of Willis via retrograde injection into the cannulated external carotid artery. High-resolution digital subtraction radiography was used to localize clots intracranially at the carotid bifurcation. Circulation through the internal carotid artery and intracranial vessels was monitored with serial digital subtraction angiography before and after embolization and during treatment. Disappearance of the tin marker on the digital subtraction radiograph indicated dissolution of clot and was associated with reestablishment of circulation on the digital subtraction angiogram. Experimental animals were treated with human-specific recombinant TPA 30 minutes, 2 hours, or 4 hours after clot embolization. TPA was administered as an intravenous bolus of 0.5 mg/kg followed by an infusion of 1 mg/kg/h for 2 hours. Digital subtraction angiograms were performed every 30 minutes. All clots dissolved, and cerebral circulation was reestablished within 120 minutes of treatment. In control animals treated with saline, embolized clots were stable, and the internal carotid artery remained occluded. At the completion of each study, the animal was perfused with freshly prepared, buffered 2,3,5-triphenyltetrazolium chloride (TTC) for demarcation of cerebral infarction. Control animals demonstrated infarction of 50 +/- 3.6% of the ipsilateral cerebral hemisphere, with an infarct weight of 2.1 +/- 0.2 g.(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定组织型纤溶酶原激活剂（TPA）在治疗栓塞性中风中的价值，对17只兔子进行了栓塞性中风模型实验。通过逆行注入插管的颈外动脉，将2小时龄、含锡的自体血栓栓塞到 Willis 环处的颈内动脉分叉处。采用高分辨率数字减影血管造影术在颅内颈动脉分叉处定位血栓。在栓塞前后及治疗期间，通过系列数字减影血管造影术监测颈内动脉和颅内血管的血流情况。数字减影放射照片上锡标记的消失表明血栓溶解，并与数字减影血管造影上血流的重新建立相关。实验动物在血栓栓塞后30分钟、2小时或4小时接受人特异性重组TPA治疗。TPA以0.5mg/kg静脉推注给药，随后以1mg/kg/h的速度输注2小时。每30分钟进行一次数字减影血管造影。所有血栓均溶解，治疗后120分钟内脑循环得以重建。在用生理盐水治疗的对照动物中，栓塞的血栓保持稳定，颈内动脉仍处于闭塞状态。在每项研究结束时，用新鲜配制的缓冲2,3,5-三苯基氯化四氮唑（TTC）灌注动物以划定脑梗死范围。对照动物同侧脑半球梗死面积为50±3.6%，梗死重量为2.1±0.2g。（摘要截断于250字）
