Results of a Multicentre, Randomised Controlled Trial of Intra-Arterial Urokinase in the Treatment of Acute Posterior Circulation Ischaemic StrokeMacleod M.R.a, b · Davis S.M.c, d · Mitchell P.J.c, e · Gerraty R.P.c · Fitt G.b, e · Hankey G.J.f · Stewart-Wynne E.G.d · Rosen D.f · McNeil J.J.g · Bladin C.F.h · Chambers B.R.a, b, d · Herkes G.K.i · Young D.a · Donnan G.A.a, b, d
aNational Stroke Research Institute, bAustin Health, cRoyal Melbourne Hospital, Departments of dNeurology and eRadiology, University of Melbourne, Melbourne, fRoyal Perth Hospital, Perth, gDepartments of Epidemiology and Preventive Medicine and hEastern Melbourne Neurosciences, Monash University, Melbourne, iRoyal North Shore Hospital and Department of Neurology, University of Sydney, Sydney, Australia
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Background: Patients with ischaemic stroke due to occlusion of the basilar or vertebral arteries may develop a rapid deterioration in neurological status leading to coma and often to death. While intra-arterial thrombolysis may be used in this context, no randomised controlled data exist to support its safety or efficacy. Methods: Randomised controlled trial of intra-arterial urokinase within 24 h of symptom onset in patients with stroke and angiographic evidence of posterior circulation vascular occlusion. Results: Sixteen patients were randomised, and there was some imbalance between groups, with more severe strokes occurring in the treatment arm. A good outcome was observed in 4 of 8 patients who received intra-arterial urokinase compared with 1 of 8 patients in the control group. Conclusions: These results support the need for a large-scale study to establish the efficacy of intra-arterial thrombolysis for acute basilar artery occlusion.
© 2005 S. Karger AG, Basel
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