Femoro-popliteal artery thrombolysis with intra-arterial infusion of recombinant tissue-type plasminogen activator--report of a pilot trial.
Recombinant tissue-type plasminogen activator (rt-PA) was infused at a rate of 10 mg/h into 50 thrombosed femoral and popliteal arteries. Patency was restored in 43 but a secondary angioplasty led to 2 reocclusions and in 3 patients early rethrombosis occurred. A favourable clinical result was thus obtained in 38 patients (76%). Thirteen bleeding complications occurred in 10 patients, mainly haematomas at puncture sites. One patient required blood transfusion for gastro-intestinal bleeding from a previously unknown ulcer. The angiographic recanalisation rate in 16 patients who received a slower infusion of rt-PA (5 or 3 mg/h) was 94% and the clinical success rate in this series was 81%. However, the incidence of bleeding complications was not decreased by the slower infusion rate. The data obtained confirm the feasibility of rt-PA thrombolysis in peripheral arterial thrombosis and warrant a comparative study with streptokinase.
Verstraete
M
M
University Hospital Gasthuisberg, University of Leuven, Belgium.
Hess
H
H
Mahler
F
F
Mietaschk
A
A
Roth
F J
FJ
Schneider
E
E
Baert
A L
AL
Verhaeghe
R
R
D000800:Angioplasty, Balloon / Q000009:adverse effects; D005263:Femoral Artery; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007261:Infusions, Intra-Arterial; D011150:Popliteal Artery; D011994:Recombinant Proteins / Q000008:administration & dosage; D012008:Recurrence; D013927:Thrombosis / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D014654:Vascular Patency / Q000187:drug effects
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator