Balloon Catheter Disruption of Middle Cerebral Artery Thrombus in Conjunction with Thrombolysis for the Treatment of Acute Middle Cerebral Artery Embolism

The goal of this study was to prospectively assess the feasibility, safety, and efficacy of balloon disruption of the middle cerebral artery (MCA) by using a deflated balloon catheter combined with an intra-arterial thrombolysis for the treatment of acute ischemic stroke. Seven consecutive patients...

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Bibliographic Details
Published in:American Journal of Neuroradiology 2007-03, Vol.28 (3), p.513-517
Main Authors: Ikushima, I, Ohta, H, Hirai, T, Yokogami, K, Miyahara, D, Maeda, N, Yamashita, Y
Format: Article
Language:English
Subjects:
Acute Disease
Adult and adolescent clinical studies
Aged
Angioplasty, Balloon
Biological and medical sciences
Cardiovascular system
Cerebral Angiography
Combined Modality Therapy
Female
Fibrinolytic Agents - administration & dosage
Humans
Infarction, Middle Cerebral Artery - diagnostic imaging
Infarction, Middle Cerebral Artery - drug therapy
Interventional
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Miscellaneous
Mood disorders
Nervous system
Pilot Projects
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Retrospective Studies
Thrombolytic Therapy
Treatment Outcome
Urokinase-Type Plasminogen Activator - administration & dosage
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Summary:The goal of this study was to prospectively assess the feasibility, safety, and efficacy of balloon disruption of the middle cerebral artery (MCA) by using a deflated balloon catheter combined with an intra-arterial thrombolysis for the treatment of acute ischemic stroke. Seven consecutive patients with clinical findings of acute major-vessel stroke met our criteria and underwent balloon disruption of an MCA thrombus with a deflated balloon catheter. The balloon disruption was performed with a low-profile microballoon catheter. The microballoon was inflated in the distal carotid artery and then deflated and advanced just distal to the occlusion site in the MCA. Thereafter, an intra-arterial thrombolysis of the MCA was applied. The maximum time from the onset of symptoms to the start of treatment and maximum dosage of urokinase was 6 hours and 600,000 U. The outcome was classified as good for a modified Rankin Scale (mRS) score of 0 or 1, moderate for a score of 2 or 3, and poor for a score of 4 or 5. Complete recanalization was achieved in 5 patients and partial recanalization in 3. Three patients recovered to an mRS score of 0 or 1; 3, to scores of 2 or 3; and 1, to a score of 4. No patients died. There was no major intracerebral hemorrhage. The penetration of the MCA with a deflated balloon catheter combined with an intra-arterial thrombolysis may be a safe and effective treatment for acute ischemic stroke.
ISSN:0195-6108
1936-959X
1432-1920