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Sequential combination of intravenous recombinant tissue plasminogen activator and intra-arterial urokinase in acute ischemic stroke

DC Field Value Language
dc.contributor.author김동익-
dc.contributor.author김서현-
dc.contributor.author김승민-
dc.contributor.author이경열-
dc.contributor.author이승익-
dc.contributor.author정해웅-
dc.contributor.author허지회-
dc.date.accessioned2015-07-14T17:26:56Z-
dc.date.available2015-07-14T17:26:56Z-
dc.date.issued2004-
dc.identifier.issn0195-6108-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/112903-
dc.description.abstractBACKGROUND AND PURPOSE: Combined intravenous (IV) and intra-arterial (IA) thrombolytic therapy may be faster and easier to initiate than monotherapy, and its recanalization rate may be better as well. The sequential combination of recombinant tissue plasminogen activator (rTPA) and urokinase (UK) has synergistic and complementary effects on clot lysis. We prospectively evaluated the effectiveness and safety of sequential combination of IV rTPA and IA UK in acute ischemic stroke. METHODS: IV rTPA was administered to patients with acute stroke within 3 hours of onset. Those whose condition had not improved at the end of rTPA infusion were further treated with selective IA UK. We evaluated baseline and 30-day National Institutes of Health Stroke Scale (NIHSS) scores and 90-day modified Rankin Scale scores. RESULTS: Thirty patients were initially treated with IV rTPA; 24 were further treated with IA UK. Four patients who had rapid reocclusion following initial successful IA therapy received IV abciximab. Fourteen of 24 patients who underwent angiography had an effective perfusion state of Thrombolysis in Myocardial Infarction grade 3 flow. Median baseline and 30-day NIHSS scores were 18 and 2, respectively. Eighteen patients improved to a modified Rankin scale score of 0 or 1 after 90 days. Symptomatic hemorrhage developed in two patients. CONCLUSION: The strategy of using conventional-dose IV rTPA and the sequential combination of IA UK in patients without an early clinical response to IV treatment was safe and feasible. This strategy achieved high complete arterial recanalization rates and good functional outcomes. Copyright American Society of Neuroradiology-
dc.description.statementOfResponsibilityopen-
dc.format.extent1470~1475-
dc.relation.isPartOfAMERICAN JOURNAL OF NEURORADIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAbciximab-
dc.subject.MESHAcute Disease-
dc.subject.MESHAdolescent-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHAntibodies, Monoclonal/administration & dosage-
dc.subject.MESHAntibodies, Monoclonal/adverse effects-
dc.subject.MESHCerebral Angiography-
dc.subject.MESHCerebral Hemorrhage/chemically induced-
dc.subject.MESHCerebral Infarction/diagnostic imaging-
dc.subject.MESHCerebral Infarction/drug therapy*-
dc.subject.MESHDrug Therapy, Combination-
dc.subject.MESHFemale-
dc.subject.MESHFibrinolytic Agents/administration & dosage*-
dc.subject.MESHFibrinolytic Agents/adverse effects-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHumans-
dc.subject.MESHImmunoglobulin Fab Fragments/administration & dosage-
dc.subject.MESHImmunoglobulin Fab Fragments/adverse effects-
dc.subject.MESHInjections, Intra-Arterial-
dc.subject.MESHInjections, Intravenous-
dc.subject.MESHIntracranial Embolism/diagnostic imaging-
dc.subject.MESHIntracranial Embolism/drug therapy*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeurologic Examination/drug effects-
dc.subject.MESHRecurrence-
dc.subject.MESHRetreatment-
dc.subject.MESHThrombolytic Therapy/methods*-
dc.subject.MESHTissue Plasminogen Activator/administration & dosage*-
dc.subject.MESHTissue Plasminogen Activator/adverse effects-
dc.subject.MESHUrokinase-Type Plasminogen Activator/administration & dosage*-
dc.subject.MESHUrokinase-Type Plasminogen Activator/adverse effects-
dc.titleSequential combination of intravenous recombinant tissue plasminogen activator and intra-arterial urokinase in acute ischemic stroke-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurology (신경과학)-
dc.contributor.googleauthorKyung Yul Lee-
dc.contributor.googleauthorDong Ik Kim-
dc.contributor.googleauthorJi Hoe Heo-
dc.contributor.googleauthorSeung Min Kim-
dc.contributor.googleauthorYong Woon Shim-
dc.contributor.googleauthorHae Woong Chung-
dc.contributor.googleauthorSeung Ik Lee-
dc.contributor.googleauthorSeo Hyun Kim-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00408-
dc.contributor.localIdA00540-
dc.contributor.localIdA00653-
dc.contributor.localIdA02648-
dc.contributor.localIdA02923-
dc.contributor.localIdA03760-
dc.contributor.localIdA04369-
dc.relation.journalcodeJ00095-
dc.identifier.eissn1936-959X-
dc.identifier.pmid15502123-
dc.contributor.alternativeNameKim, Dong Ik-
dc.contributor.alternativeNameKim, Seo Hyun-
dc.contributor.alternativeNameKim, Seung Min-
dc.contributor.alternativeNameLee, Kyung Yul-
dc.contributor.alternativeNameLee, Seung Ik-
dc.contributor.alternativeNameChung, Hae Woong-
dc.contributor.alternativeNameHeo, Ji Hoe-
dc.contributor.affiliatedAuthorKim, Dong Ik-
dc.contributor.affiliatedAuthorKim, Seo Hyun-
dc.contributor.affiliatedAuthorKim, Seung Min-
dc.contributor.affiliatedAuthorLee, Kyung Yul-
dc.contributor.affiliatedAuthorLee, Seung Ik-
dc.contributor.affiliatedAuthorChung, Hae Woong-
dc.contributor.affiliatedAuthorHeo, Ji Hoe-
dc.rights.accessRightsfree-
dc.citation.volume25-
dc.citation.number9-
dc.citation.startPage1470-
dc.citation.endPage1475-
dc.identifier.bibliographicCitationAMERICAN JOURNAL OF NEURORADIOLOGY, Vol.25(9) : 1470-1475, 2004-
dc.identifier.rimsid36785-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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