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Titolo:
Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis
Autore:
Wasay, M; Bakshi, R; Kojan, S; Bobustuc, G; Dubey, N; Unwin, DH;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Neurol, Houston, TX 77225 USA Univ Texas Houston TX USA 77225 i Ctr, Dept Neurol, Houston, TX 77225 USA Univ Texas, SW Med Ctr, Dept Neurol, Dallas, TX 75235 USA Univ Texas Dallas TX USA 75235 Med Ctr, Dept Neurol, Dallas, TX 75235 USA Univ Texas, SW Med Ctr, Mobil Fdn Ctr, Dallas, TX 75235 USA Univ Texas Dallas TX USA 75235 d Ctr, Mobil Fdn Ctr, Dallas, TX 75235 USA Kaleida Hlth, Imaging Serv, Buffalo, NY USA Kaleida Hlth Buffalo NY USAKaleida Hlth, Imaging Serv, Buffalo, NY USA SUNY Buffalo, Dept Neurol, Buffalo, NY 14260 USA SUNY Buffalo Buffalo NY USA 14260 alo, Dept Neurol, Buffalo, NY 14260 USA Aga Khan Univ, Dept Neurol, Karachi, Pakistan Aga Khan Univ Karachi Pakistan han Univ, Dept Neurol, Karachi, Pakistan
Titolo Testata:
STROKE
fascicolo: 10, volume: 32, anno: 2001,
pagine: 2310 - 2316
SICI:
0039-2499(200110)32:10<2310:NCOLUT>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL VENOUS THROMBOSIS; DURAL SINUS; ENDOVASCULAR THROMBOLYSIS; SELECTIVE CATHETERIZATION; THERAPY; INFUSION;
Keywords:
anticoagulants; cerebral thrombosis; heparin; thrombolysis; urokinase;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Bakshi, R Buffalo Neuroimaging Anal Ctr, 100 High St,Suite E-2, Buffalo, NY 14203 USA Buffalo Neuroimaging Anal Ctr 100 High St,Suite E-2 Buffalo NY USA 14203
Citazione:
M. Wasay et al., "Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis", STROKE, 32(10), 2001, pp. 2310-2316

Abstract

Background and Purpose-We sought to compare the safety and efficacy of direct urokinase thrombolysis with systemic heparin anticoagulation for superior sagittal sinus thrombosis (SSST). Methods-At University at Buffalo (NY) and University of Texas (Dallas, Houston), we reviewed 40 consecutive patients with SSST, treated with local urokinase (thrombolysis group) or systemic heparin anticoagulation (heparin group). The thrombolysis group (n=20) received local urokinase into the SSS followed by systemic heparin anticoagulation. The heparin group (n=20) received systemic heparin anticoagulation only. Neurological dysfunction was rated as follows: 0, normal; 1, mild (but able to ambulate and communicate); 2, moderate (unable to ambulate, normal mentation); and 3, severe (unable to ambulate, altered mentation). Results-Age (P=0.49), sex (P=0.20), baseline venous infarction (P=0.73), and predisposing illnesses (P=0.52) were similar between the thrombolysis and heparin groups. Pretreatment neurological function was worse in the thrombolysis group (normal, n=5; mild, n=8; moderate, n=4; severe, n=3) than in the heparin group (normal, n=8; mild, n=8; moderate, n=3; severe, n=1) (P=NS). Discharge neurological function was better in the thrombolysis group (normal, n=16; mild, n=3; moderate, n=1; severe, n=0) than in the heparin group (normal, n=9; mild, n=6; moderate, n=5; severe, n=0) (P=0.019, Mann-Whitney U test). Hemorrhagic complications were 10% (n=2) in the thrombolysis group (subdural hematoma, retroperitoneal hemorrhage) and none in the heparin group (P=0.49). Three of the heparin group patients developed complications of the underlying disease (status epilepticus, hydrocephalus, refractorypapilledema). No deaths occurred. Length of hospital stay was similar between the groups (P=0.79). Conclusions-Local thrombolysis with urokinase is fairly well tolerated andmay be more effective than systemic heparin anticoagulation alone in treating SSST. A randomized, prospective study comparing these 2 treatments for SSST is warranted.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 01:20:02