TY - JOUR T1 - Balloon Catheter Disruption of Middle Cerebral Artery Thrombus in Conjunction with Thrombolysis for the Treatment of Acute Middle Cerebral Artery Embolism JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 513 LP - 517 VL - 28 IS - 3 AU - I. Ikushima AU - H. Ohta AU - T. Hirai AU - K. Yokogami AU - D. Miyahara AU - N. Maeda AU - Y. Yamashita Y1 - 2007/03/01 UR - http://www.ajnr.org/content/28/3/513.abstract N2 - BACKGROUND AND PURPOSE: The goal of this study was to prospectively assess the feasibility, safety, and efficacy of balloon disruption of the middle cerebral artery (MCA) by using a deflated balloon catheter combined with an intra-arterial thrombolysis for the treatment of acute ischemic stroke.MATERIALS AND METHODS: Seven consecutive patients with clinical findings of acute major-vessel stroke met our criteria and underwent balloon disruption of an MCA thrombus with a deflated balloon catheter. The balloon disruption was performed with a low-profile microballoon catheter. The microballoon was inflated in the distal carotid artery and then deflated and advanced just distal to the occlusion site in the MCA. Thereafter, an intra-arterial thrombolysis of the MCA was applied. The maximum time from the onset of symptoms to the start of treatment and maximum dosage of urokinase was 6 hours and 600,000 U. The outcome was classified as good for a modified Rankin Scale (mRS) score of 0 or 1, moderate for a score of 2 or 3, and poor for a score of 4 or 5.RESULTS: Complete recanalization was achieved in 5 patients and partial recanalization in 3. Three patients recovered to an mRS score of 0 or 1; 3, to scores of 2 or 3; and 1, to a score of 4. No patients died. There was no major intracerebral hemorrhage.CONCLUSIONS: The penetration of the MCA with a deflated balloon catheter combined with an intra-arterial thrombolysis may be a safe and effective treatment for acute ischemic stroke. ER -