Recombinant human tissue-type plasminogen activator for thrombolysis in peripheral arteries and bypass grafts.
Recombinant human tissue-type plasminogen activator (rt-PA) was infused intraarterially at 0.1 mg/kg/h for 1-6 1/2 hours in 25 patients with lower extremity thromboembolic occlusions (13 thrombosed arteries, 12 thrombosed bypass grafts). Occlusion duration ranged from 1 hour to 21 days. Thrombolysis occurred in 23 of 25 patients (92%). Time to lysis varied from 1 to 6.5 hours, with an average time of 3.6 hours. Twenty of 23 patients (87%) in whom thrombolysis was successful benefited clinically from thrombolytic therapy. Twelve of 23 patients (52%) required secondary procedures to maintain arterial segment patency. In 15 of 25 patients (60%) fibrinogen levels were maintained above 50% of baseline values. No major complications directly attributable to rt-PA infusions occurred. rt-PA is a potent, relatively fibrin-specific thrombolytic agent that can achieve rapid thrombolysis while usually avoiding the profound systemic fibrinogenolysis associated with currently available thrombolytic agents.
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002986:Clinical Trials as Topic; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006083:Graft Occlusion, Vascular / Q000188:drug therapy*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011859:Radiography; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013927:Thrombosis / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator