The beneficial effect of intracarotid urokinase on acute stroke in a baboon model

Abstract

The capacity of intracarotid Infusion of urokinase to salvage neurologic function in a baboon model of acute thrombotk stroke has been studied. The model consists of reversible eccentric balloon compression (3 hours) of the right middle cerebral artery (MCA) proximal to the take-off of the lentlculo-striate arteries (LSA), resulting in in situ thrombosis of perforating branches supplying the right corpus striatum. Neurologic endpoints included quantitative assessment of neurologic function (NE), estimation of cerebral infarction volume by computerized tomographic (CT) scan, and carotid angiography. In untreated acute stroke control animals (n = 6), a persistent decrease in functional score (from 100 to 36 ± 11) at 14 days and a defined region of cerebral infarction (volume = 3.2 ± 1.5) were detected at 10 days. Intracarotid urokinase administered to five animals (1.2 × 106 IU) over 60 min) following the 3 hour period of MCA occlusion improved neurologic function (NE = 50, 55, 85, 100, 100) and reduced infarction size (0.3, 0.5, 0.8,0.7,1.1 cm3, respectively) without evidence of intracranial hemorrhage. Systemk fibrinogenolysis was produced in all five treated animals. We conclude that thrombolytic therapy given within 3 hours of experimental thrombotic ocdusion may salvage neurologic function and reduce cerebral Infarction volume without CT scan detectable intracranial bleeding. © 1986 American Heart Association, Inc.