Selective Intra-Arterial Fibrinolysis of Acute Central Retinal Artery Occlusion
نویسندگان
چکیده
Background and Purpose—Occlusion of the central retinal artery (CRAO) causes a sudden decrease of monocular vision. Because early restoration of blood flow may improve outcome, we attempted to treat CRAO with selective intra-arterial fibrinolysis. Methods—Intra-arterial fibrinolysis was performed within 6 hours after symptom onset in 17 patients with thromboembolic CRAO. Symptoms were painless, acute and severe decrease of vision. Urokinase (100 000 to 900 000 IU) was given through a microcatheter into the ophthalmic artery over 10 to 90 minutes. For comparison, the history and visual outcome of 15 control patients who did not receive fibrinolytics were evaluated. In both groups some of the patients underwent paracentesis and/or received carboanhydrase inhibitors. Results—Patients who underwent fibrinolysis fared better than control patients (P50.01). Three patients (17.6%) recovered completely after fibrinolysis and regained visual acuity of 20/20 (n52) to 25/20 (n51). Two additional patients (11.8%) showed a marked improvement to a visual acuity of 20/30. In 6 patients (35.3%) vision improved slightly. They were able to count fingers, detect hand movements, or perceive light. In 6 patients (35.3%), fibrinolytic treatment was without effect. Among control patients, 1 patient (6.7%) showed partial, 4 patients (26.7%) minimal, and 10 (66.7%) no improvement of vision. Conclusions—A complete or marked improvement of visual acuity was achieved in one third of intra-arterial fibrinolysis patients but in none of the control patients. Intra-arterial fibrinolysis seems to have the potential to “lighten” the spontaneously poor outcome of CRAO. (Stroke. 1998;29:2076-2079.)
منابع مشابه
Intra-Arterial Fibrinolysis Not Recommended for Central Retinal Artery Occlusion Central Retinal Artery Occlusion: Local Intra-Arterial Fibrinolysis Versus Conservative Treatment, A Multicenter Randomized Trial
Objective: To evaluate the safety and efficacy of local intra-arterial fibrinolysis with tissue plasminogen activator (tPA) in the management of patients with central retinal artery occlusion. Design: Prospective randomized multicenter clinical trial (the European Assessment Group for Lysis in the Eye study). Methods: 9 centers in Austria and Germany recruited 84 patients with central retinal a...
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Intraarterial fibrinolysis was performed in three patients with acute central retinal artery occlusion using recombinant tissue plasminogen activator as a fibrinolytic agent. In two cases the ophthalmic artery was selectively catheterized, and in the other a thrombolytic drug was infused into the ophthalmic artery by way of the meningeal collaterals. All patients experienced visual improvement....
متن کاملSelective intraarterial fibrinolysis of acute central retinal artery occlusion.
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