Urokinase clears blot clots in stroke patients

Endovascular mechanical thrombectomy has been the gold standard procedure for treating stroke patients with an occluded cerebral artery since 2015 because it improves reperfusion. A Swiss research team at University Hospital Bern has now demonstrated that treatment with thromolytics such as urokinase can further co reduce the degree of disability, without increasing the risk of bleeding.

The patients analyzed in the study published in JAMA Neurology showed residual peripheral occlusions subsequent to mechanical thrombectomy, which led to an almost complete rather than a complete reperfusion. The team headed by Johannes Kaesmacher demonstrated that peripheral occlusions could be dissolved by pre-surgical arterial administration of urokinase, which was areflected by better reperfusion and a better outcome in patients.

The risk of symptomatic bleeding after the urokinase administration was only 5.2% versus 6.9% in the control group.  Further studies are still needed for a widespread use of this procedure, and a pan-European, multicenter study is already well under way, said Prof. Dr. Jan Gralla, the neuroradiological senior author of the study.