A comparison of human recombinant tissue-type plasminogen activator and urokinase in microsurgical thrombolysis in the rat.
A comparison was made between several characteristics of tissue-type plasminogen activator (t-PA) and urokinase (UK), potentially useful in microsurgery to restore perfusion to ischemic free-tissue transfers. An intraarterial infusion of one of the drugs (or normal saline [NS] as a control) was performed in conjunction with a rat femoral vein clot model. Both t-PA and urokinase were effective in lysing 100 percent of the venous clots on the side of infusion. This occurred in only 25 percent of controls (p = .0035). Thrombolysis on the contralateral side, a measure of systemic effect, occurred in 38 percent, 50 percent, and 13 percent of veins using t-PA, UK, and NS, respectively (t-PA vs. UK p = 1.0, t-PA vs. NS p = .28, UK vs. NS p = .14). Rethrombosis occurred in 13 percent and 25 percent of ipsilateral veins treated with t-PA and urokinase, respectively, and in one of the two veins that had resumed flow during saline infusion (t-PA vs. UK p = .30) Scanning electron microscopy was performed 4 hr and 48 hr after thrombolysis. No differences between thrombolytic agents was noted in terms of residual thrombus and vessel characteristics. The data suggest that t-PA and urokinase are effective, with no clear advantage of one agent over the other.
Levy
E A
EA
Department of Surgery, Indiana University Medical Center, Indianapolis 46202.
Sadove
A M
AM
Eppley
B L
BL
Evan
A P
AP
D000714:Anastomosis, Surgical; D000818:Animals; D005268:Femoral Vein / Q000601:surgery; D007261:Infusions, Intra-Arterial; D008297:Male; D008855:Microscopy, Electron, Scanning; D051381:Rats; D011919:Rats, Inbred Strains; D011994:Recombinant Proteins / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator