PMID: 9432174Feb 12, 1998Paper

Local intraarterial fibrinolysis of thromboemboli occurring during endovascular treatment of intracerebral aneurysm: a comparison of anatomic results and clinical outcome.

AJNR. American Journal of Neuroradiology
M CronqvistJ Moret

Abstract

We describe our therapeutic strategy and correlate the anatomic results and clinical outcomes in patients who received immediate fibrinolytic therapy for thromboembolic complications occurring during endovascular treatment of an intracerebral aneurysm. The medical records and angiographic examinations of 19 patients were reviewed. All endovascular procedures were performed with the patients under general anesthesia and fully heparinized. Thirteen patients received an intravenous bolus injection of aspirin. Thromboemboli occurred during catheterization or insertion of embolic material (Guglielmi detachable coils or mechanical detachable spirals) or in the first hours after the intervention. Clot distribution was within the MCA territory in 14 patients, the ACA in three patients, and the basilar trunk in two patients. A continuous intraarterial injection of urokinase was administered immediately, either superselectively distal to the thrombus or selectively within or closely proximal to the thrombus. In nine cases, chemical lysis was combined with mechanical clot fragmentation. Initial anatomic recanalization as well as clinical outcome at 3 months were evaluated. Ten patients showed complete recanalization and nine patients show...Continue Reading

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