Zeumer H, Freitag H J, Zanella F, Thie A, Arning C
Department of Neuroradiology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany.
Neuroradiology. 1993;35(2):159-62. doi: 10.1007/BF00593977.
A group of 59 patients with stroke due to acute vertebrobasilar or carotid territory occlusion have been treated by local intra-arterial fibrinolysis (LIF). A high recanalisation rate was accomplished with either urokinase or recombinant tissue plasminogen activator (r-TPA). However, with either substance, even if a high dose was used, recanalisation was a time-consuming process which usually took 120 min. A reasonable explanation for the lack of effectiveness of these plasminogen-activating substances might be a deficit of substrate, e.g. plasminogen, in aged thrombus. LIF was capable of improving clinical outcome in acute vertebrobasilar artery occlusion, reducing mortality to 50% in patients fulfilling inclusion criteria. In the carotid territory multiple occlusions had a poor prognosis while good clinical results could be achieved in occlusions of the proximal middle cerebral artery or single branches.
一组59例因急性椎基底动脉或颈动脉供血区闭塞导致中风的患者接受了局部动脉内溶栓治疗（LIF）。使用尿激酶或重组组织型纤溶酶原激活剂（r-TPA）均实现了较高的再通率。然而，无论使用哪种物质，即使使用高剂量，再通也是一个耗时的过程，通常需要120分钟。这些纤溶酶原激活物质缺乏有效性的一个合理解释可能是老年血栓中底物（如纤溶酶原）的缺乏。LIF能够改善急性椎基底动脉闭塞的临床结局，使符合纳入标准的患者死亡率降至50%。在颈动脉供血区，多处闭塞预后较差，而大脑中动脉近端或单支闭塞则可取得良好的临床效果。
