Acute peripheral arterial and graft occlusion: treatment with selective infusion of urokinase and lysyl plasminogen.
Thirty-five patients hospitalized for recent angiographically documented arterial occlusion in the legs (27 femoropopliteal arteries and eight grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a 4- or 5-F catheter. This therapy combined a continuous urokinase (UK) infusion of 1,000 U/kg/hour and a lysyl plasminogen (LYS-PLG) infusion of 15 microkatals every 30 minutes. Angiographically confirmed lysis was obtained in 85% of the cases. Only 3% of the patients had major and 6% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK-LYS-PLG is as effective as streptokinase. Its excellent tolerance makes it a good alternative in the treatment of acute ischemia in the lower limbs.
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002404:Catheterization / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005342:Fibrinolysis; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000009:adverse effects; D010958:Plasminogen / Q000008:administration & dosage* / Q000009:adverse effects / Q000032:analysis; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011859:Radiography; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D000979:alpha-2-Antiplasmin / Q000032:analysis
D010446:Peptide Fragments; D000979:alpha-2-Antiplasmin; C018998:lysyl-plasminogen; D010958:Plasminogen; D014568:Urokinase-Type Plasminogen Activator