Clinical study on rt-PA intraarterial thrombolysis for acute ischemic stroke

Objective To investigate the curative effect and complications of intra-arterial thrombolysis (IAT) with recombinant tissue plasminogen activator(rt-PA) for patients with acute ischemic stroke, and analyse the factors related the outcomes.Methods 12 patients were treated by IAT with rt-PA in our hospital from Oct.2002 to Oct.2003. Primary neuroradiological assessment was performed with CT in all patients. Mechanical disruption of clot remnants were attempted after rt-PA infusion. Angiographic recanalization was classified according to thrombolysis in myocardial infarction (TIMI) grades. Clinical evaluation was undertaken 20 d after thrombolysis with classification of modified rankin scale (MRS) scores, good for 0 to 3 and poor for 4 to 6. Results Before thrombolysis the scores for TIMI 1 in 1 case was 8.33% and TIMI 0 in 11 cases was 91.67%. The rates of complete or partial recanalization just after IAT were 75%(9/12), less or no recanalization were 25%(3/12). Good outcome in 66.7%(8/12), poor outcome in 33.33%(4/12). Cerebral hemorrhage occurred in 1 case.Conclusions Intra-arterial thrombolysis ( IAT) with rt-PA is feasible and safe in treatment of acute ischemic stroke.