Intraoperative urokinase infusion for embolic stroke during carotid endarterectomy

J. D. Barr, M. B. Horowitz, J. M. Mathis, R. J. Sclabassi, H. Yonas, I. S. Ciric, C. H. Tator

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

EMBOLIC STROKE IS an infrequent complication of carotid endarterectomy. Somatosensory evoked potential monitoring detected delayed acute neurological deterioration during endarterectomy performed on a 71-year-old woman. Intraoperative arteriography performed via an indwelling shunt revealed thrombus within the middle cerebral artery and distal branches. A microcatheter was placed into the internal carotid artery via the arteriotomy and advanced into the middle cerebral artery. Urokinase was infused into and around the thrombus until almost complete thrombolysis had been achieved. The patient recovered quickly and was discharged without neurological deficit.

Original languageEnglish (US)
Pages (from-to)606-611
Number of pages6
JournalNeurosurgery
Volume36
Issue number3
DOIs
StatePublished - Mar 1995

Keywords

  • Carotid
  • Cerebral embolism and thrombosis
  • Endarterectomy
  • Fibrinolysis
  • Thrombolytic therapy
  • Urokinase

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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