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Thrombolytic treatment of clot embolism in rat - Comparison of intra-arterial and intravenous application of recombinant tissue plasminogen activator

MPG-Autoren
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Niessen,  Frank
Konstantin-Alexander Hossmann, Emeriti, Max Planck Institute for Metabolism Research, Managing Director: Jens Brüning, Max Planck Society;

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Hilger,  Thomas
Konstantin-Alexander Hossmann, Emeriti, Max Planck Institute for Metabolism Research, Managing Director: Jens Brüning, Max Planck Society;

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Hoehn,  Mathias
In-vivo-NMR, Research Groups, Max Planck Institute for Metabolism Research, Managing Director: Jens Brüning, Max Planck Society;

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Hossmann,  Konstantin-Alexander
Konstantin-Alexander Hossmann, Emeriti, Max Planck Institute for Metabolism Research, Managing Director: Jens Brüning, Max Planck Society;

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Zitation

Niessen, F., Hilger, T., Hoehn, M., & Hossmann, K.-A. (2002). Thrombolytic treatment of clot embolism in rat - Comparison of intra-arterial and intravenous application of recombinant tissue plasminogen activator. Stroke, 33(12), 2999-3005.


Zitierlink: http://hdl.handle.net/11858/00-001M-0000-0026-DA46-C
Zusammenfassung
Copyright 2002 American Heart Association, Inc.
Background and Purpose-We sought to test the hypothesis that intra-arterial recombinant tissue plasminogen activator (rtPA) treatment of thromboembolic stroke is more efficient than intravenous application. Methods-Rats were embolized by intracarotid injection of autologous fibrin-rich blood clots. One hour later rtPA (10 mg/kg) was infused either intravenously (n=8) or intra-arterially (n=8). Control rats (n=8) received intra-arterial infusion of saline. Treatment was monitored by MR perfusion-weighted imaging and apparent diffusion coefficient (ADC) imaging, and outcome was evaluated by comparing incidence of hemorrhages and lesion volumes of ATP and pH. Results-Clot embolism led to a decline of perfusion- weighted imaging signal intensity in the middle cerebral artery territory to <40% of control. Both intra-arterial and intravenous treatment significantly improved blood flow in cerebral cortex but not in caudate putamen. In untreated animals, ATP and pH lesion volumes were 510.3+/-94.5 and 438.6+/-39.2 mm(3) at 7 hours after clot embolism, respectively. Both intravenous and intra-arterial rtPA treatment produced hemorrhagic complications but reduced ATP lesion size to 296.2+/-136.1 and 370.3+/-103.7 mm(3) and reduced pH lesion size to 263.3+/-114.6 and 303.3+/-103.0 mm(3), respectively (P<0.05 for untreated versus treated rats; no difference between intravenous and intra-arterial treatment). ADC imaging revealed that lesion reduction was due to inhibition of infarct growth but not to reversal of primary injury. Conclusions-This study documents reduction of injury by rtPA treatment but does not reveal a difference between intra- arterial and intravenous application. Our data do not support an advantage of intra-arterial thrombolysis.