Experimental Evaluation Of Intraarterial Thrombolysis With Recombinant Staphylokinase In Canine Model With Acute Cerebral Infarction

Objective To evaluate the efficacy, complications of thrombolysis for treatment of acute cerebral infarction with recombinant staphylokinase via different routes in dogs, and compared with urokinase (UK).Methods The model of left intemal cerebral embolism was established with interventional technique in 40 beagle adult dogs, which were randomly divided into 5 groups including control group, intraarterial group, combined (intra-arterial and intravenous) group, intravenous group and UK group. The cerebral angiography was performded 5 hours(or 3 hrs in intravenous group) after embolization.. Thrombolytic agents were infused through left internal carotid artery or left femoral vein within 30 rain (10ml of saline in control group, 10,000U/kg of r-Sak in each r-sak groups, 10,000U/kg of in UK groups). Angiography was repeated half, 1 and 2 hours after thrombolysis to observe recanalization. Blood samples were collected to determine activated partial prothrombin time, thrombin time, D-dimer pre- and at 30 min, 60 min, 120rain after thrombolysis. The behavior of these canines was observed and then sacrificed at 24 hours after thrombolysis for pathologic study.Results The recanalization rate of embolized cerebral arteries at 2 hours after thrombolysis was 0%, 93.3%, 92.8%, 37.5% and 33.3% in control group, intraarterial group, combined (intra-arterial and intravenous) group, intravenous group and UK group, respectively. And the complete recanalization rate was 0%, 60.0%, 57.1%, 6.7%, and 6.7%, respectively. There was significant change in the rate of efficacy in each r-sak groups and UK group at 1 and 2 hours after thrombolysis compared with the control group (p＜0.05). There statistically was higher rate of efficacy and of complete recanalization in intra-arterial group and combined group at 2 hours than that in intravenous group and UK group (p＜0.05).Conclusions Thrombolysis with r-sak is a more effective treatment for canine models with acute cerebral infarction than UK. Intraarterial and combined intraarterial-intravenous thrombolysis can more effectively dissolve thrombi in the cerebral vessels than intravenous thrombolysis.