Basics and Standard of Acute Local Intra-arterial Fibrinolysis

Acute local intra-arteriral fibrinolysis (LIF) should be neutrally evaluated at present. The efficacy of LIF have never been evaluated objectively, and standard pre-therapeutic evaluation and therapeutic technique has never been established. Regarding to the efficacy, PROACT II was performed and finished in the USA, but a final decision is still pending. MELT Japan is now underway in Japan. The subject of both these studies is middle cerebral artery embolism, so no such study exist for basilar artery embolism. Standard pre-therapeutic evaluation and therapeutic technique are established in MELT Japan. The patient in whom LIF can be started within 6 hours after onset, with an NIH stroke scale of 5 to 22, without ischemic lesion in the cerebral cortex can be enrolled in MELT Japan.