title: Regional infusion of urokinase into occluded lower-extremity bypass grafts: long-term clinical results.
abstract: The initial outcome, long-term patency rate, and rate of limb salvage were studied in patients after regional urokinase infusion for treatment of thrombosed lower-extremity grafts. Seventy-one infusions were performed in 53 patients. Complete clot lysis occurred in 75% of grafts, with establishment of antegrade blood flow in 66%. Variables that favorably influenced clot lysis and the reestablishment of antegrade blood flow through the graft were a short duration of occlusion and a suprainguinal graft position. The median duration of patency after infusion and adjunctive therapy was 162 days, with 75% limb salvage at 301 days. No statistically significant variables that influenced the length of patency were identified. These long-term patency results are inferior to the reported results in suprainguinal grafts after reoperation. They appear similar to reported results for occluded infrainguinal grafts treated with thrombectomy and patch grafting.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston.
authors.forename: J D
authors.initials: JD
authors.lastname: Durham
authors.forename: S C
authors.initials: SC
authors.lastname: Geller
authors.forename: W M
authors.initials: WM
authors.lastname: Abbott
authors.forename: H
authors.initials: H
authors.lastname: Shapiro
authors.forename: A C
authors.initials: AC
authors.lastname: Waltman
authors.forename: T G
authors.initials: TG
authors.lastname: Walker
authors.forename: D C
authors.initials: DC
authors.lastname: Brewster
authors.forename: C A
authors.initials: CA
authors.lastname: Athanasoulis
mesh_terms: D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000503:physiopathology; D006085:Graft Survival; D006801:Humans; D007261:Infusions, Intra-Arterial; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014654:Vascular Patency
chemical_list: D014568:Urokinase-Type Plasminogen Activator