[Macroembolism as a complication of ultra-high dose urokinase lysis of occlusion of a bifurcation prosthesis].
The case of a 70-year-old woman suffering from a long occlusion of the right branch of an aortobifemoral dacron-graft implanted six years ago is reported. Patency could be achieved by a systemic application of an ultrahigh dose of urokinase (UHUK = 9,000,000 I.U/6 h, intermittent daily application, two cycles). As a major complication macro-embolism to the popliteal artery and to the superficial femoral artery occurred, however. A further cycle of UHUK, local thrombolytic therapy (12 mg rtPA) and surgical thrombectomy failed to achieve persistent recanalization. So the patient finally had to be provided with a femoro-crural composite bypass. In conclusion, in a systemic thrombolytic therapy of occlusions of dacron grafts in the aorto-iliacal area a standard dose of urokinase (initial dose 600,000 I.U., maintenance dose 150,000 I.U./h, infusion pump) is recommended.
Katzenschlager
R
R
Universitätsklinik für Innere Medizin II, Abteilung für Angiologie, Wien.
Koppensteiner
R
R
Minar
E
E
Muhm
M
M
Stümpflen
A
A
Ugurluoglu
A
A
Huk
I
I
Ehringer
H
H
D000368:Aged; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D017128:Embolectomy; D004617:Embolism / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*
D011093:Polyethylene Terephthalates; D014568:Urokinase-Type Plasminogen Activator
Makroembolie als Komplikation bei ultrahochdosierter Urokinaselyse eines Bifurkationsprothesenverschlusses.