LYS-PLASMINOGEN AS AN ADJUNCT TO LOCAL INTRAARTERIAL FIBRINOLYSIS FORCAROTID TERRITORY STROKE - LABORATORY AND CLINICAL FINDINGS

To improve the efficacy of local intraarterial fibrinolysis (LIF), we compared different fibrinolytic drugs in a cerebral circulation model in the laboratory. The technical efficacy of fibrinolysis, defined as the clot volume lysed per unit time, was found to be optimal with r-ti ssue plasminogen activator (TPA) activated lys-plasminogen (= plasmin) . Subsequently, 20 patients with stroke due to carotid artery territor y occlusion were treated by local intrarterial fibrinolysis using the plasmin regimen. The angiographic data and clinical outcome of these p atients were compared with those of 40 patients who received plasminog en activators (urokinase or r-TPA) only. Laboratory and clinical data confirmed that plasmin lysis is superior to treatment using only plasm inogen activators.