Thrombolytic therapy for acute occlusion of the vertebrobasilar artery

Vascular injuries after a clavicle fracture are rare. The treatment remains, if possible, conservative. In case of life-threatening bleeding or limb ischemia, endovascular treatment is the treatment of choice. In this case report, we describe a patient who suffered a clavicle fracture five years before and now presented with acute invalidating claudication caused by an acute occlusion superimposed on a brachial artery stenosis. After unsuccessful thrombolytic therapy a surgical exploration of the brachial artery was performed.

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Intraarterial Thrombolytic Therapy for Acute Vertebrobasilar Artery Occlusions in 5 Patients.

Nihon Kyukyu Igakukai Zasshi ◽

10.3893/jjaam.12.739 ◽

2001 ◽

Vol 12 (12) ◽

pp. 739-744

Author(s):

Hirotaka Okumura ◽

Hiroshi Tenjin ◽

Fumio Asakura ◽

Noriaki Sugawa

Keyword(s):

Thrombolytic Therapy ◽

Vertebrobasilar Artery

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Thrombolytic Therapy for Thromboembolism of Vertebrobasilar Artery

Angiology ◽

10.1177/000331978303400901 ◽

1983 ◽

Vol 34 (9) ◽

pp. 561-571 ◽

Cited By ~ 63

Author(s):

G.G. Nenci ◽

P. Gresele ◽

M. Taramelli ◽

G. Agnelli ◽

E. Signorini

Keyword(s):

Thrombolytic Therapy ◽

Vertebrobasilar Artery

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Long-Term Follow-Up of Patients after Intraarterial Thrombolytic Therapy of Acute Vertebrobasilar Artery Occlusion

Cerebrovascular Diseases ◽

10.1159/000047706 ◽

2001 ◽

Vol 12 (3) ◽

pp. 214-219 ◽

Cited By ~ 21

Author(s):

Ulrich Sliwka ◽

Michael Mull ◽

Angelika Stelzer ◽

Rolf Diehl ◽

Johannes Noth

Keyword(s):

Thrombolytic Therapy ◽

Artery Occlusion ◽

Vertebrobasilar Artery ◽

Long Term Follow Up ◽

Vertebrobasilar Artery Occlusion

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Evoked potential monitoring during acute occlusion of the basilar artery and selective local thrombolytic therapy

Archiv für Psychiatrie und Nervenkrankheiten ◽

10.1007/bf00344069 ◽

1982 ◽

Vol 232 (6) ◽

pp. 541-548 ◽

Cited By ~ 20

Author(s):

Werner Hacke ◽

Elisabeth Berg-Dammer ◽

Hermann Zeumer

Keyword(s):

Thrombolytic Therapy ◽

Basilar Artery ◽

Evoked Potential ◽

Acute Occlusion ◽

Local Thrombolytic Therapy ◽

Evoked Potential Monitoring ◽

Potential Monitoring

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Percutaneous Transluminal Angioplasty for Intracranial Arteriosclerotic Lesions

Interventional Neuroradiology ◽

10.1177/15910199970030s206 ◽

1997 ◽

Vol 3 (2_suppl) ◽

pp. 41-46 ◽

Cited By ~ 2

Author(s):

H. Yokote ◽

T. Terada ◽

K. Ryujin ◽

Y. Kinoshita ◽

M. Tsuura ◽

...

Keyword(s):

Thrombolytic Therapy ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Acute Occlusion ◽

Balloon Catheters ◽

Recent Developments ◽

Intracranial Arteries ◽

Cerebral Ischemic ◽

Percutaneous Transluminal

Recent developments of the interventional neuroradiological technique made percutaneous transluminal angioplasty (PTA) possible even for intracranial arteries1. We report our experiences of 17 cases treated by PTA including 9 intracranial internal carotid (ICA), 4 middle cerebral (MCA) and 4 vertebro-basilar arterial (VBA) stenoses and discuss the problems of the procedure. All patients had cerebral ischemic symptoms and stenoses more than 60% calculated angiographically. Three of them were treated by PTA for residual stenoses after thrombolytic therapy for acute occlusion. We used PTA balloon catheters 2.0 mm to 3.5 mm in diameter (Stealth, Target therapeutics) for all PTA procedures. A PTA balloon was inflated for 1 min at 6 atm as a rule. All were successfully dilated (stenosis less than 50%) except one treated by PTA for residual MCA stenosis after thrombolytic therapy. The patient died from massive infarction due to MCA re-occlusion caused by MCA dissection. Restenosis appeared in 4 of 16 patients. Repeated PTA was successfuly carried out for the 4 patients. However, restenosis appeared in one of them but the patient is now on follow-up because of asymptomatic course. PTA for intracranial arteries is an effective treatment but its indication should be determined strictly because of potential risk such as acute occlusion derived from dissection.

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