Thrombolysis with prourokinase versus urokinase: an in vitro comparison.
OBJECTIVE
Despite advantages demonstrated in vitro, no single thrombolytic agent has been clearly shown to be superior to another in the clinical setting. Prourokinase has recently received attention as a new thrombolytic agent with higher fibrin specificity. The thrombolytic activity of prourokinase, however, remains ill defined. The purpose of this study was to evaluate thrombolysis with prourokinase in comparison to urokinase in vitro.


METHODS
We used an in vitro parallel channel perfusion model that simulates catheter-directed thrombolysis in the peripheral arterial system. Radiolabeled thrombi were subjected to 90 minutes of endhole catheter-directed infusion with either prourokinase 5000 IU/ml, urokinase 5000 IU/ml; or 5% dextrose in water at 4 ml/hr.


RESULTS
Prourokinase and urokinase were found to be equivalent with respect to thrombolytic effect. Percent lysis was maximal at 90 minutes in both the urokinase and prourokinase groups. Prourokinase and urokinase were found to be equally effective in restoring flow through thrombosed graft segments.


CONCLUSIONS
Prourokinase appears to offer little benefit over urokinase with respect to thrombolytic activity in an in vitro model that closely resembles the clinical setting. If prourokinase is to be accepted as an alternative to urokinase, advantages must relate to differences in fibrin specificity.
Fox
D
D
Department of Surgery, University of Rochester, New York 14642, USA.
Ouriel
K
K
Green
R M
RM
Stoughton
J
J
Riggs
P
P
Cimino
C
C
D002404:Catheterization; D004792:Enzyme Precursors / Q000008:administration & dosage / Q000494:pharmacology*; D005337:Fibrin / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous; D007457:Iodine Radioisotopes; D008961:Models, Structural; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000494:pharmacology*; D011994:Recombinant Proteins / Q000494:pharmacology; D012039:Regional Blood Flow; D013927:Thrombosis / Q000503:physiopathology; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000494:pharmacology*
D004792:Enzyme Precursors; D005343:Fibrinolytic Agents; D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D005337:Fibrin; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator; D005947:Glucose; C067551:saruplase