Intra-arterial thrombolysis in patients with acute ischemic stroke: choice of time window

Objective To evaluate the safety and efficacy of local intra-arterial thrombolysis (LIT) using urokinase in patients with acute stroke. Methods Radiological findings and functional outcome 3 months after LIT with urokinase of 217 patients were analyzed and scored with Glasgow outcome scale. Results Angiography showed occlusion of the cerebral artery in 217 patients, of the internal carotid artery segment in 119 (54.83%), and of the vertebrobasilar artery segment in 43 (19.82%). Negative result was found in 55 (25.35%) patients. After intra-arterial treatment with urokinase, successful recanalization was observed in 103 (63.58%) of 162 patients with arterial occlusions. During the 90 days following-up, 56 (25.80%) of the 217 patients had a good outcome, 51 (23.50%) had disabilities, 59 (27.19%) had deformities and 22 (10.14%) had unconscious, but 29 (13.36%) patients died. Hemorrhage occurred in 8 (3.69%) of the trial, and only one survived by physics treatment. Reperfusion injury occurred in 73 (33.64%) patients, arterial reocclusion occurred in 6 ((2.76%)) patients. Conclusion LIT with urokinase is safe and effective therapy in the treatment of acute ischemic stroke. The time window of LIT should be considered some longer than 6 hours.