Since 1994, we have treated 62 cases with hyperacute cerebral embolism with local intraarterial thrombolysis (LIT), but not all cases showed recanalization. We tried to classify these cases by angiographic results. Angiographically they could be classified into four types; tapering type, fading type, stump type, and edge type. The tapering and fading type had a significantly higher tendency to recanalize than the stump and edge type.
We think these classifications indicate the dissolubility of the cerebral emboli; the former two types dissoluble, the latter two types indissoluble. The tapering and fading type are the good indicators for LIT, but the stump and edge type may not be.
FukazawaSWakiR: Angiographic A-V shunt during interventional thrombolysis for acute cerebral embolism. Interventional Neuroradiology3 (suppl 2): 75–78, 1997.
3.
MoriETabuchiM: Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke19: 802–812, 1988.
4.
HackeWZeumerH: Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke19: 1216–1222, 1988.
5.
BollaertPEBracardS: Early local intra-arterial thrombolysis for severe middle cerebral artery stroke. Cerebrovasc Dis5: 292–296, 1995.
6.
GönnerFRemondaL: Local intra-arterial thrombolysis in acute ischemic stroke. Stroke29: 1894–1900, 1998.
7.
BendszusMUrbachH: Outcome after local intraarterial fibrinolysis compared with the natural course of patients with a dense middle cerebral artery on early CT. Neuroradiology40: 54–58, 1998.
8.
del ZoppoGJFerbertA: Local intra-arterial fibrinolytic therapy in acute carotid territory stroke. A pilot study. Stroke19: 307–313, 1988.
9.
del ZoppoGJHigashidaRT: PROACT; A phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. Stroke29: 4–11, 1998.
10.
SasakiOTakeuchiS: Fibrinolytic therapy for acute embolic stroke: Intravenous, intra-carotid, and intra-arterial local approaches. Neurosurgery36: 246–253, 1995.
11.
EzuraMKagawaS: Selective and superselective infusion of urokinase for embolic stroke. Surg Neurol38, 353–358, 1992.
12.
BarnwellSLClarkWM: Safety and efficacy of delayed intraarterial urokinase therapy with mechanical clot disruption for thromboembolic stroke. Am J Neuroradiol15: 1817–1822, 1994.
13.
JansenOvon KummerR: Thrombolytic therapy in acute occlusion of the intracranial internal carotid artery bifurcation. Am J Neuroradiol16: 1977–1986, 1995.
