The role of recombinant pro-urokinase (r-pro-UK) and intra-arterial thrombolysis in acute ischaemic stroke: the PROACT trials. Prolyse in Acute Cerebral Thromboembolism

Abstract

By delivering a higher concentration of drug directly into a clot, intra-arterial (IA) thrombolysis may be more effective than intravenous therapy at opening a blocked artery. The clinical efficacy and safety of IA thrombolysis with the selective thrombolytic r-pro-urokinase (r-pro-UK) has been demonstrated in two randomized acute stroke treatment trials, PROACT I and PROACT II. However, IA pro-UK is not yet FDA approved, and it is not known if IA thrombolysis with other agents would have the same results. However the American Heart Association has deemed IA thrombolysis an 'acceptable alternative therapy' and many stroke centres are offering it to patients with a major acute stroke presenting within 6 h.