title: Two urokinase dose regimens in native arterial and graft occlusions: initial results of a prospective, randomized clinical trial.
abstract: The effects of two urokinase (UK) dose regimens on lysis time, lytic success, primary clinical success, and frequency of complications of peripheral thrombolysis were compared. Seventy-two intraarterial UK infusions were performed by means of standard catheter-directed infusion techniques in 63 patients with symptomatic peripheral arterial or bypass graft occlusions. Patients were prospectively randomized to high-dose (250,000 U/h for 4 hours and then 125,000 U/h) or low-dose (50,000 U/h) regimens. The mean time to complete lysis was 20.8, 26.0, 16.5, and 18.2 hours for the high-dose artery, low-dose artery, high-dose graft, and low-dose graft groups, respectively (P was not significant). Respective mean infusion durations were 27.1, 35.4, 22.2, and 25.3 hours. Clinical success was achieved in 65%-85% of cases. The frequency of complications was equivalent between groups, except for a higher frequency of minor bleeding complications in the high-dose group. The two urokinase dose regimens studied were equally effective in enabling peripheral thrombolysis.
authors.affiliation: Department of Radiology, University of Iowa College of Medicine, Iowa City.
authors.forename: A H
authors.initials: AH
authors.lastname: Cragg
authors.forename: T P
authors.initials: TP
authors.lastname: Smith
authors.forename: J D
authors.initials: JD
authors.lastname: Corson
authors.forename: N
authors.initials: N
authors.lastname: Nakagawa
authors.forename: F
authors.initials: F
authors.lastname: Castaneda
authors.forename: T F
authors.initials: TF
authors.lastname: Kresowik
authors.forename: W J
authors.initials: WJ
authors.lastname: Sharp
authors.forename: A
authors.initials: A
authors.lastname: Shamma
authors.forename: K S
authors.initials: KS
authors.lastname: Berbaum
mesh_terms: D000792:Angiography; D005121:Extremities / Q000098:blood supply; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014568:Urokinase-Type Plasminogen Activator