[Loco-regional fibrinolysis in peripheral arterial bypasses. Our experience].
Thirty-one patients (29 males and 2 females) with 34 thrombosed grafts were treated by direct intra-arterial infusion of urokinase; the lesions were acute in 27 cases and chronic (2-4 months) in 4. Urokinase was infused in doses of 50,000 UI/h. Angiographic follow-up exams were performed every 12 hours. The infusion was stopped when lumen patency was re-established and there was no significant mural thrombus or peripheral embolus. Treatment usually lasted 4-72 hours (average: 18 hours). The hematological status was controlled by measuring plasma fibrinogen, coagulation time, partial thromboplastin time, prothrombin and antiplasmin time. Initial success rate was 76% (23 patients). Overall 1-year patency was 56% in 23 cases: 85% in the patients with correctable lesions by means of surgery or PTA, and 46% in the patients with non-correctable lesions. After the first period, patency remained high in the patients followed up to 5 years. Our experience confirms that lysis of a thrombosed graft is possible by the local infusion of a low-dose fibrinolytic agent and exhibits high success rate and low complication rate in acute and chronic obstructions.
Lupattelli
L
L
Istituto di Radiologia, Università, Perugia.
Barzi
F
F
Mosca
S
S
Maselli
A
A
Pozzilli
P
P
Farsini
D
D
Cao
P G
PG
Verzini
F
F
D000368:Aged; D000792:Angiography; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D014568:Urokinase-Type Plasminogen Activator
La fibrinolisi loco-regionale nei bypass arteriosi periferici. Nostra esperienza.