[The adjuvant use of the monoclonal antibody c7E3 Fab in peripheral arterial thrombolysis].
Thrombolysis of arterial occlusions has limitations, e.g. it requires extensive time for thrombolysis, occlusions may be resistant to lysis, and the rate of reocclusions may be high. c7E3 Fab inhibits platelet aggregation by binding to the GPIIb/IIIa receptor on platelets. Experimentally, this monoclonal antibody has been shown to decrease, the time required for lysis, and to prevent reocclusion. This is the first report on the adjunctive use of c7E3 Fab in peripheral arterial occlusions in humans. Three patients with occlusion of the iliac or femoropopliteal artery were treated with c7E3 Fab (bolus injection of 0.25 mg/kg KG + i.v.-application 12 micrograms/min for 12 h). In addition, the patients received urokinase (100,000 IU bolus + 100,000 IU/h). Heparin (5,000 IU bolus + 1,000 IU/h) and acetylsalicylate (100 mg/day/p.o.). Occlusion length ranged between 6-40 cm. Therapy was successful in all patients. During the follow-up period (4-6 months) no reocclusion occurred. There were no serious side effects like major bleeding or thrombocytopenia. We conclude that the applied doses appear safe. Even the time required for thrombolysis was short, a conclusion in respect of a significant reduction of the time required for lysis can be drawn only after further controlled studies.
Tepe
G
G
Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität, Tübingen.
Duda
S H
SH
Erley
C M
CM
Schott
U
U
Huppert
P E
PE
Claussen
C D
CD
D000077284:Abciximab; D000368:Aged; D015901:Angiography, Digital Subtraction; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator; D000077284:Abciximab
Adjuvanter Einsatz des monoklonalen Antikörpers c7E3 Fab bei peripherer arterieller Thrombolyse.