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Basilar artery thrombolysis

Elderly lady came with sudden unconsciouness of 4 hours duration. MRI showed no flow in basilar artery.
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Right vertebral angiogram AP view shows complete occlusion of basilar artery.
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Guide wire  has crossed the clot in the basilar artery.
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After injecting 5 mg of tissue plasminogen activator (tPA) , no significant clot dissolution is seen.
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After 10 mg of the tPA -basilar thrombus has got dissolved significantly. Basilar artery and its major  branches are filling now.
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After 15 mg tPA, no further improvement is seen
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After 15 mg tpa- Basilar artery is seen well in lateral view. Posterior cerebral arteries are filling upto their proximal half.

 

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