title: Thrombolytic treatment of pulmonary embolism with APSAC.
abstract: BRL 26921 (Eminase registered trade mark in Belgium, Germany and The Netherlands) is the p-anisoyl derivative of the primary (human) lys plasminogen-streptokinase activator complex (APSAC). The acyl-enzyme has the theoretical advantage of causing fibrinolysis in situ in the presence of fibrin clotbound plasminogen. It was administered to 34 patients with severe pulmonary embolism (PE) in an open multicentre study. PE was suspected on clinical, blood gas, ECG, and radiographic data. Pulmonary angiograms performed pre- and post-treatment confirmed the diagnosis and were assessed using the Miller Index (MI). Fibrinogen, plasminogen, alpha-2-antiplasmin, fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), partial thromboplastin time (PTT) were closely monitored before and after each administration of APSAC. Median angiographic improvement was 50% (range 0-94%). The following adverse events were reported: bleeding at puncture sites (n = 12), haematuria (n = 1), epistaxis (n = 3), fever (n = 2). A blood transfusion was given in one patient with an inguinal haematoma. Systemic fibrinogenolysis occurred in 20/28 patients.
authors.affiliation: Dept of Intensive Care, University Hospital, Antwerp, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Vander Sande
authors.forename: L
authors.initials: L
authors.lastname: Bossaert
authors.forename: M
authors.initials: M
authors.lastname: Brochier
authors.forename: B
authors.initials: B
authors.lastname: Charbonnier
authors.forename: A
authors.initials: A
authors.lastname: Serradigmini
authors.forename: A
authors.initials: A
authors.lastname: Elias
authors.forename: H
authors.initials: H
authors.lastname: Pintens
authors.forename: M C
authors.initials: MC
authors.lastname: Lauwers
mesh_terms: D000328:Adult; D000368:Aged; D016255:Anistreplase; D001777:Blood Coagulation / Q000187:drug effects; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010958:Plasminogen / Q000009:adverse effects / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D016255:Anistreplase; D010958:Plasminogen; D013300:Streptokinase