[Local low dosage thrombolysis with rt-PA. Systemic effects on the fibrinolytic system--data on the assessment of the value and risk of this method].
We investigated 70 patients suffering from peripheral vascular disease for alterations in fibrinolytic parameters before, during and twice after local, low dose thrombolysis with rt-PA (1 - 7.5 mg). Recanalization was achieved in all 10 embolic occlusions and in 87% of 60 thrombotic occlusions. We found no alterations of fibrinogen and plasminogen plasma levels, but significant consumption of antiplasmin 5 min after the end of rt-PA application. Degradation products of fibrinogen and fibrin showed a parallel increase only during the therapy. PAI I concentrations significantly increased until the 2nd day after the therapy. Since we limited the maximum dose of rt-PA to 7.5 mg we never saw systemic bleeding or embolisation in more than 300 cases.
von Bilderling
P
P
Privatklinik Josephinum, München.
Spannagl
M
M
Mietaschk
A
A
Iven
M
M
Schramm
W
W
Hess
H
H
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004617:Embolism / Q000097:blood* / Q000628:therapy*; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000097:blood* / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
Die lokale, niedrig dosierte Thrombolyse mit rt-PA. Systemische Auswirkungen auf das Fibrinolysesystem--Daten zur Einschätzung von Leistungsfähigkeit und Risiko der Methode.