Ismail A Khatri, Atif Rana, Afifa Kulsoom.
Intraarterial thrombolysis with reteplase in acute ischaemic stroke in a Pakistani center.
J Pak Med Assoc Jan ;58(7):408-11.

Acute ischaemic stroke is a major cause of neurological morbidity and mortality across the globe. Recent advances in past two decades have made complete reversal of life threatening stroke a reality. The judicious use of intravenous and intraarterial thrombolysis in acute ischaemic stroke has saved countless lives. The use of thrombolytic therapy in Pakistan in acute stroke is still miniscule. Very limited literature is available from Pakistan on the use of intravenous thrombolysis. Intraarterial thrombolysis has been used only in few patients and there are no published reports of that from Pakistan. We present the case of a young man who came within 1 hour of stroke onset with a large right middle cerebral artery infarct resulting in severe neurological deficit. An urgent cerebral angiography showed complete occlusion of right internal carotid artery at its bifurcation. Successful intraarterial thrombolysis was performed with excellent clinical outcome. To our knowledge this is the first report of use of intraarterial thrombolysis in acute stroke from Pakistan.

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