METHODS AND RESULTS: The effect of filament-induced intracerebral
thrombus formation and embolization was investigated after a one-hour occlusion of the middle cerebral artery. In accordance with previous studies, treatment with 10 mg/kg rtPA significantly improved functional outcome,
cerebral infarct size and
edema, but also resulted in markedly increased intracranial
bleeding volumes. In contrast, low doses of rtPA (0.1 or 0.35 mg/kg
body weight) did not change outcome parameters. However, addition of 1 mg/kg
Revacept to 0.35 mg/kg rtPA led to improved reperfusion compared to rtPA alone. Moreover, these combined treatments resulted in improved grip strength, compared to the respective dose of rtPA alone.
Infarct-surrounding
edema improved after combined treatments, but not after respective single rtPA dosings. Intracranial
bleeding volumes were below controls after all low-dose rtPA
therapies, given either alone or combined with
Revacept.
CONCLUSIONS: In contrast to using the equally effective full dose of rtPA, intracranial
bleeding was not increased by low-dose rtPA combined with
Revacept. Therefore, addition of
Revacept to low-dose rtPA does not incur safety risks, but improves efficacy of treatment.