Effect of intrathecal thrombolytic therapy on subarachnoid clot and chronic vasospasm in a primate model of SAH.

摘要: The safety and efficacy of the thrombolytic agent tissue-type plasminogen activator (tPA) in elimination subarachnoid clot prevention chronic vasospasm were evaluated a blind randomized placebo-controlled trial. Twenty-four monkeys randomly assigned to one two groups 12. Each group underwent baseline cerebral angiography coagulation analysis followed by right-sided craniectomy experimental hemorrhage (SAH). An Ommaya reservoir was inserted with its catheter placed into space. hours later (the tPA group) received 0.5 mg ml buffer injected every 8 for three doses, while second placebo same volume normal saline. On Day 7, repeated animals sacrificed. One animal from developed delayed ischemic neurological deficit on 5 after SAH. Moderate severe (greater than 30% reduction vessel caliber) present 7 internal carotid middle arteries (p less 0.01), only mild narrowing anterior artery seen. No significant change status occurred either group. All had large amount remaining at time sacrifice, but 11 12 completely free clot. results electron microscopic studies correlated angiography, there no histological evidence brain inflammation associated intrathecal use tPA.