Local thrombolysis in peripheral arteries and bypass grafts.
Sixty-two patients hospitalized for recent angiographically documented arterial occlusion in the legs (46 femoropopliteal arteries and 16 grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a No. 4F or No. 5F catheter. This therapy combined a continuous urokinase (UK) infusion of 1000 U/kg/hr and a lysyl plasminogen (LYS-PLG) infusion of 15 mukat every 30 minutes. Angiographically confirmed lysis was obtained in 77% of the cases. Five percent of the patients had major and 8% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK and LYS-PLG is as effective as streptokinase but produces lower systemic fibrinolysis. However, local fibrinolysis remains a potentially hazardous procedure (10% suffered major complications) and must only be applied to patients with severe ischemia and little or no possibility of surgical intervention.
Pernes
J M
JM
Department of Cardiovascular Radiology, Hôpital Broussais, Paris, France.
de Almeida Augusto
M
M
Vitoux
J F
JF
Raynaud
A
A
Fiessinger
J N
JN
Brenot
P
P
Fabiani
J N
JN
Murday
A
A
Gaux
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D002406:Catheterization, Peripheral / Q000009:adverse effects; D004338:Drug Combinations; D004617:Embolism / Q000209:etiology; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications; 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*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D004338:Drug Combinations; D010446:Peptide Fragments; C018998:lysyl-plasminogen; D010958:Plasminogen; D014568:Urokinase-Type Plasminogen Activator