Local thrombolytic therapy for thromboembolic occlusion of the middle cerebral artery

Abstract

We report on 10 patients with thromboembolic occlusion of the middle cerebral artery (MCA) who underwent local thrombolytic therapy. Six patients developed a MCA occlusion during long-standing interventional neuroradiological procedures, while four had a proven or suspected cardio-embolic stroke. Streptokinase or urokinase was applied by a microcatheter placed into the thrombus within six hours of clinical onset. Complete or partial revascularization was achieved in all patients. Recovery was complete in seven and partial in three of the patients. In two patients, minor haemorrhagic transformation of the infarct occurred, which did not lead to neurological deterioration. It is concluded that in a selected group of patients with MCA occlusion, local thrombolytic therapy represents a safe and effective therapy.