BACKGROUND AND PURPOSE: To test the safety and recanalization efficacy of intra-arterial local delivery of plasminogen activators in acute @entity385 , a randomized trial of recombinant pro-urokinase (rpro-UK) versus placebo was undertaken in @entity1 with angiographically documented proximal @entity2500 . METHODS: After exclusion of @entity932 by CT scan, @entity1 with abrupt onset of symptoms of focal @entity63 likely to receive treatment within 6 hours who satisfied all clinical eligibility criteria underwent carotid angiography. @entity1 displaying Thrombolysis in Acute @entity583 or 1 occlusion of the M1 or M2 middle cerebral artery were randomized 2:1 to receive rpro-UK (6 mg) or placebo over 120 minutes into the proximal thrombus face. All @entity1 received intravenous heparin. Recanalization efficacy was assessed at the end of the 2-hour infusion, and @entity1779 causing @entity16 was assessed at 24 hours. RESULTS: Of 105 @entity1 who underwent angiography, 59 were excluded from randomization. Among the 46 @entity1 randomized, 40 were treated with rpro-UK (n=26) or placebo (n=14) a median of 5.5 hours from symptom onset. Recanalization was significantly associated with rpro-UK (2P=.017). Hemorrhagic transformation causing @entity16 within 24 hours of treatment occurred in 15.4% of the rpro-UK-treated @entity1 and 7.1% of the placebo-treated @entity1 (2P=.64). Both recanalization and @entity548 frequencies were influenced by heparin dose. CONCLUSIONS: Intra-arterial local rpro-UK infusion was associated with superior recanalization in acute thrombotic/ @entity64 compared with placebo. In this regimen, heparin dose influenced @entity548 frequency and recanalization. Although @entity548 remains a concern, this study suggests that recanalization is enhanced with rpro-UK and heparin.

PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute XXXX . PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity932 :: ('MESH:D020300', 'Disease') :: ['intracranial hemorrhage'] @entity64 :: ('MESH:D020521', 'Disease') :: ['thromboembolic stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage', 'symptomatic hemorrhage'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity2500 :: ('MESH:D020244', 'Disease') :: ['middle cerebral artery occlusion'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological deterioration'] @entity583 :: ('MESH:D009203', 'Disease') :: ['Myocardial Infarction grade 0'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral hemorrhage'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity2500 :: (MESH:D020244,Disease) :: ['middle cerebral artery stroke']
