Complications of intraarterial urokinase-lys-plasminogen infusion therapy in arterial ischemia of lower limbs.
Thirty-five patients with peripheral arterial occlusions were treated by intraarterial infusion of low-dose urokinase associated with bolus of lys-plasminogen. Thrombolysis was achieved in 26 cases (74%), but only 10 patients (28.5%) experienced sustained improvement. Complications of thrombolysis occurred in 11 patients: Five patients developed groin hematoma, five had distal emboli, and one experienced macroscopic hematuria. Catheter-related thrombosis was observed in 14 patients (40%) despite intravenous heparin. Nine patients suffered from recurrent thrombosis and three from proximal emboli. A patient died from catheter-related infection. Limited fibrinolysis could increase pericatheter thrombosis, and further work will be necessary to assess the local risk of intraarterial thrombolysis.
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000188:drug therapy*; D002404:Catheterization / Q000009:adverse effects; D004617:Embolism / Q000209:etiology; D005260:Female; D006406:Hematoma / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D007261:Infusions, Intra-Arterial / Q000009:adverse effects; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010958:Plasminogen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012306:Risk; D013927:Thrombosis / Q000209:etiology; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D010446:Peptide Fragments; C018998:lysyl-plasminogen; D010958:Plasminogen; D014568:Urokinase-Type Plasminogen Activator