Changes in Coagulation and Fibrinolytic System after Local Intra-arterial Thrombolysis for Acute Ischemic Stroke
スポンサーリンク
概要
- 論文の詳細を見る
Intracerebral hemorrhagic transformation is one of the most important complications of thrombolytic therapy for acute ischemic stroke. The relationship between changes in markers for the coagulation and fibrinolytic systems and occurrence of hemorrhagic transformation was determined after local intra-arterial thrombolytic therapy using urokinase (UK) (24 patients) or recombinant tissue plasminogen activator (t-PA) (10 patients) within 6 hours of onset. All 34 patients had no hypodensity areas on initial computed tomography scans. Plasma concentrations of fibrinogen-fibrin degradation products (FDP), fibrinogen, α_2-plasmin inhibitor (α_2-PI), plasmin-α_2 plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT), and D-dimer were measured. Hemorrhagic transformation occurred in seven patients (21%) with complete or partial recanalization; four in the UK group and three in the t-PA group. Doses of the thrombolytic agents did not correlate with the incidence of hemorrhagic transformation. The FDP levels in the hemorrhagic transformation group treated with UK significantly increased immediately and 1 hour after the therapy. The α_2-PI activities decreased and PIC levels increased in both the hemorrhagic transformation and the nonhemorrhagic groups after the therapy. The TAT levels in both groups tended to be higher than the normal range, but there was no significant difference from the pretreatment levels. The D-dimer levels in the hemorrhagic transformation group were higher than those in the nonhemorrhagic group at 24 hours after the therapy. Furthermore, the D-dimer levels were significantly higher in patients with complete recanalization compared with those with none or partial recanalization. Activation of the fibrinolytic system after thrombolytic therapy may be a risk factor for intracerebral hemorrhagic transformation. D-dimer is useful as a marker for recanalization in thrombolytic therapy for acute ischemic stroke.
- 日本脳神経外科学会の論文
- 1995-03-15
著者
-
HATAKEYAMA Takao
Department of Neurosurgery, Uwajima City Hospital
-
Hatakeyama Takao
Department Of Neurological Surgery Ehime University School Of Medicine
-
KUMON Yoshiaki
Department of Neurosurgery, Ehime University Graduate School of Medicine
-
Uraoka Tadao
Department of Cardiology, Kita Medical Association Hospital
-
Kumon Yoshiaki
Departments Of Neurological Surgery Ehime University School Of Medicine
-
Kumon Yoshiaki
Department Of Integrated Medicine And Informatics Ehime Graduate School Of Medicine
-
SAKAKI Saburo
Department of Neurosurgery,Osaka Koseinenkin Hospital
-
Uraoka Tadao
Department Of Cardiology Kita Medical Association Hospital
-
Uraoka Tadao
Department Of Internal Medicine Kita-ishikai Hospital
-
UEDA Toshihiro
Department of Earth and Planetaly Sciences, Graduate School of Sciences, Kyushu University
-
OHTA Shinsuke
Department of Neurological Surgery, Ehime University School of Medicine
-
Kumon Yoshiaki
Department Of Neurological Surgery Ehime University School Of Medicine
-
Ueda Toshihiro
Department Of Neurological Surgery Ehime University School Of Medicine
-
Ueda Toshihiro
Department Of Earth And Planetaly Sciences Graduate School Of Sciences Kyushu University
-
Ohta Shinsuke
Department Of Neurological Surgery Ehime University School Of Medicine
-
Sakaki Saburo
Department Of Neurological Surgery Ehime University School Of Medicine
-
Sakaki Saburo
Department Of Neurological Surgery Ehime University Medical School
関連論文
- Pituitary Metastasis from Carcinoma of the Urinory Bladder Mimuicking Pituitary Apoplexy : Case Report
- Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery
- Intracoronary Administration of a Thromboxane A_2 Synthase Inhibitor Relieves Acetyicholine-Induced Coronary Spasm
- Magnesium Deficiency in Patients With Recent Myocardial Infarction and Provoked Coronary Artery Spasm
- Clinical Characteristics of Female Patients With Coronary Spastic Angina : Comparison With Male Patients
- Recommendations for performing acetylcholine tests safely : STOP dangerous complications induced by acetylcholine tests (STOP DCIAT)
- A long-acting calcium antagonist over one year did not improve BMIPP myocardial scintigraphic imagings in patients with pure coronary spastic angina
- New Combined Spasm Provocation Test in Patients With Rest Angina : Intracoronary Injection of Acetylcholine After Intracoronary Administration of Ergonovine
- Investigation of the Most Effective Provocation Test for Patients With Coronary Spastic Angina : Usefulness of Accelerated Exercise Following Hyperventilation
- A Case of Variant Angina Pectoris With Similar Findings on Both Rest and Matched Exercise Thallium-201 Studies
- A-41. Two Cases of Dumbbell Type Tumor in the Incisural Region.
- 55 55. Experience of Postoperative Course of a Case with Brain Tumor presenting Adrenal Insufficiency and Diabetes Insipidus
- 51 51. Experiences of Cases with Tumors lying within and adjacent to Incisura Tentorii
- 27 Postoperative Management by Rewarming from Hypothermia in Brain Operation
- Total Removal of an Intramedullary Meningioma of the Medulla Oblongata : Case Report
- Intracerebellar Hematoma in a Term Newborn Secondary to an Angiomatous Malformation : Case Report
- Collisional destruction experiment of chondrules and formation of fragments in the solar nebula
- PE-566 The Plasma Osteopontin Level, both Full Length and Fragmented Form Elevated at the Vulnerable Plaque(PE095,Atherosclerosis (Clinical/Pathophysiology) (IHD),Poster Session (English),The 73rd Annual Scientific Meeting of the Japanese Circulation Soci
- OE-043 Osteopontin and C-reactive Protein Co-localize in Atherosclerotic Plaques(Atherosclerosis, clinical-01, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Discrimination of Brain Abscess and Cystic Tumor by In Vivo Proton Magnetic Resonance Spectroscopy
- Primary Spinal Chondrosarcoma Localized in the Cervical Spinal Canal and Intervertebral Foramen : Case Report
- Chronic Subdural Hematoma Associated with Middle Fossa Arachnoid Cysts : Three Case Reports
- Transvenous Embolization of Carotid-Cavernous Sinus Fistula Associated with a Primitive Trigeminal Artery : Case Report
- Changes in Coagulation and Fibrinolytic System after Local Intra-arterial Thrombolysis for Acute Ischemic Stroke
- Large Cystic Cavernous Angioma of the Cerebellum : Case Report
- Pediatric Orbital Eosinophilic Granuloma with Intra- and Extracranial Extension : Case Report
- Combined Carotid Endarterectomy and Cardiac Surgery for Concomitant Carotid and Cardiac Disease
- MECHANISM OF VENOUS CONGESTION IN SYSTEMIC AND PULMONARY CIRCULATORY SYSTEMS : Pulmonary circulation Peripheral circulation : FREE COMMUNICATIONS (Abstract) : 45 Annual Scientific Meeting, Japanese Circulation Society
- Association of Meningioma and Ependymoma : Case Report
- Primary Ewing's Sarcoma of the Occipital Bone : Case Report
- Huge Facial Schwannoma Extending Into the Middle Cranial Fossa and Cerebellopontine Angle Without Facial Nerve Palsy
- Coronary Artery Spasm Provocation Test by Simultaneous Brachial Artery and Vein Approach with the Tometakun Hemostat
- Hyperacute stroke patients and catheter thrombolysis therapy : correlation between computed tomography perfusion maps and final infarction
- Intraorbital Encephalocele in an Adult Patient Presenting With Pulsatile Exophthalmos : Case Report
- Coronary abnormal response has increased in Japanese patients : Analysis of 17 years' spasm provocation tests in 2093 cases
- 47 On the Study of Hemorrhagic Lesions of Brain Stem in Head Injury
- A-18. A Clinico-Pathological Study on the Mechanism of the Onset of Symptoms in the Cases of Chronic Subdural Hematoma
- Foramen Magnum Decompression for Syringomyelia Associated with Basilar Impression and Chiari I Malformation : Report of Three Cases
- Need for Documentation of Guidelines for Coronary Artery Spasm : An Investigation by Questionnaire in Japan
- Apatite Deposition on Several Dental Biodegradable Materials in Simulated Body Fluid
- Spontaneous Carotid-Cavernous Fistulas
- Plasma thrombin-cleaved osteopontin elevation after carotid artery stenting in symptomatic ischemic stroke patients
- Cerebral and Subdural Abscess With Spatio-temporal Multiplicity 12 Years After Initial Craniotomy for Acute Subdural Hematoma : Case Report
- A case of meningitis due to Neisseria subflava after ventriculostomy
- Inflammatory Pseudotumor in the Lateral Ventricle : Case Report
- New Protocol to Detect Coronary Spastic Angina without Fixed Stenosis.
- Comparative Results of Coronary Intervention in Patients With Variant Angina Versus Those With Non-Variant Angina.