Guide wire traversal test: retrospective study of results with fibrinolytic therapy.
The validity of the guide wire traversal test as a predictor of the outcome of selective fibrinolytic infusion therapy was investigated. A retrospective analysis of 51 consecutive urokinase infusions at the authors' institution revealed that the initial attempt at guide wire traversal of clotted vessels was successful in 36 patients and unsuccessful in 15. In those 15 patients in whom the initial guide wire traversal was unsuccessful, urokinase was infused proximal to the occlusion for 2-8 hours. In 10 of these 15 vessels, either guide wire traversal (n = 7) or complete lysis with only proximal infusion (n = 3) was then achieved. Final results for this group of 15 patients were similar to those found in the group of 36 patients in whom initial attempts at guide wire traversal were successful (chi 2 contingency analysis, P greater than .8). There were no statistically significant differences between these two groups with regard to ages of the grafts, duration of vessel occlusion prior to treatment, infusion times, or patient gender composition. These data indicate that failure to traverse a clotted vessel with a guide wire does not preclude successful urokinase fibrinolytic therapy in a substantial percentage of patients.
Smith
D C
DC
Department of Radiology, Loma Linda University Medical Center, CA 92354.
McCormick
M J
MJ
Jensen
D A
DA
Westengard
J C
JC
D000368:Aged; D002404:Catheterization / Q000379:methods; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy* / Q000453:epidemiology; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D014568:Urokinase-Type Plasminogen Activator