Feasibility of arterial blood bypass using microcatheter in intraarterial thrombolysis for acute cerebral ischemic stroke / 中华放射学杂志

ABSTRACT

Objective To assess the feasibility of arterial blood bypass using microcatheter in intraarterial thrombolysis for acute cerebral ischemic stroke.Methods Six patients with acute cerebral infarction within 6 hours underwent intraarterial thrombolysis,in which arterial blood bypass was used.A 2.3 F microcatheter was advanced through the clot and two milliliters of contrast was injected beyond the clot that remained stagnant in the major branches.At this point,20 ml of oxygenated blood from femoral artery was injected for 2 minutes through the microcatheter past the occluding clot Then,conventional intraarterial thrombolysis,including fibrinolytic agents infusion and mechanical disruption,was performed.Intraarterial thrombolysis and oxygenated blood infusion alternated every 30 minutes.Results Every patient received arterial blood bypass with average three times(from 1 to 5 times)in the process of the intraarterial thrombolysis,which cost(8.0±3.2)min.Recanalization was achieved in all 6 patients,but minor subarachnoid hemorrhage developed in one patient All the patients got favorable clinical outcome.The life conditions is excellent in 4 cases and good in 2 cases.Conclusions Arterial blood bypass using microcatheter in intraarterial thrombolysis for acute cerebral ischemic stroke might be feasible,which did not interfere with conventional intraarterial thrombolysis and prolong the operation time significantly but could protect ischemic penumbra.