[Urokinase in refractory lower leg ulcers: therapy with retrograde intravenous pressure infusion].
20 patients with large, resistant leg ulcers were treated by retrograde local intravenous pressure infusions containing 100,000 to 200,000 I.U. of urokinase 3 times per week for a total of up to 12 weeks. Laser-Doppler flowmetry and transcutaneous oxygen measurement at the ulcer borders showed highly pathological findings before therapy demonstrating a severe disturbance of local microcirculation in every case. After therapy the clinical condition was markedly improved in 17 cases. There was an increase of Laser-Doppler indices (peak flux/resting flux) and of tc pO2 and a statistically significant decrease of plasma viscosity and of plasma fibrinogen. The beneficial effects may be explained by fibrinolysis of intra- and extracapillary fibrin and by hemodynamic changes caused by repeated limb occlusions.
Dermatologischen Abteilung, Wilhelminenspitals der Stadt Wien.
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Partsch
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Jochmann
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000187:drug effects; D010478:Chemotherapy, Cancer, Regional Perfusion; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007871:Leg Ulcer / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012039:Regional Blood Flow / Q000187:drug effects; D012867:Skin / Q000098:blood supply; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000493:pharmacokinetics
D014568:Urokinase-Type Plasminogen Activator; D010100:Oxygen