Intra-arterial urokinase for treatment of retrograde thrombosis following resection of an arteriovenous malformation. Case report

E. P. Sipos, J. R. Kirsch, H. J.W. Nauta, G. Debrun, J. A. Ulatowski, W. R. Bell

Research output: Contribution to journalArticle

8 Scopus citations


Retrograde thrombosis of feeding arteries is a potentially catastrophic complication occasionally reported following resection of arteriovenous malformations (AVM's). No successful therapy for this condition, which causes postoperative stroke, has previously been reported. A case of retrograde thrombosis of the left middle cerebral artery immediately following resection of a parietal AVM is reported in a patient with a retained intra-arterial catheter from preoperative embolization. The administration of urokinase within 4 hours of surgery resulted in dramatic clinical and angiographic improvement without hemorrhagic complications. While urokinase is considered highly experimental in this setting, this case demonstrates that thrombolytic agents should be viewed as therapeutic options worthy of further investigation.

Original languageEnglish (US)
Pages (from-to)1004-1007
Number of pages4
JournalJournal of neurosurgery
Issue number6
StatePublished - Jan 1 1992



  • arteriovenous malformation
  • embolization
  • retrograde thrombosis
  • thrombolytic therapy
  • urokinase

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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