INTRAOPERATIVE UROKINASE INFUSION FOR EMBOLIC STROKE DURING CAROTID ENDARTERECTOMY

EMBOLIC STROKE IS an infrequent complication of carotid endarterectomy . Somatosensory evoked potential monitoring detected delayed acute neu rological deterioration during endarterectomy performed on a 71-year-o ld woman. Intraoperative arteriography per formed via an indwelling sh unt revealed thrombus within the middle cerebral artery and distal bra nches. A microcatheter was placed into the internal carotid artery via the arteriotomy and advanced into the middle cerebral artery. Urokina se was infused into and around the thrombus until almost complete thro mbolysis had been achieved. The patient recovered quickly and was disc harged without neurological deficit.