Dialysis access graft thrombolysis: randomized study of pulse-spray versus continuous urokinase infusion.
OBJECTIVE
To compare pulse-spray to continuous-infusion thrombolysis with high-dose urokinase in thrombosed dialysis access grafts.


METHODS
A prospective randomized controlled trial was performed. From August 1992 to September 1993, 30 thrombosed polytetrafluoroethylene (PTFE) grafts in 24 patients were included, 15 grafts in each group. The success of thrombolysis, mean time to thrombolysis, mean urokinase dose, and 60-day patency rate were evaluated.


RESULTS
In the pulse-spray group, the mean time to thrombolysis was 72 min with a mean urokinase dose of 560,000 U. The 60-day patency rate was 71%. In the continuous-infusion group, the mean infusion time to thrombolysis was 55 min with a mean dose of 479,000 U. The 60-day patency rate was 73%.


CONCLUSIONS
No statistically significant difference was found between the two techniques in the mean time to thrombolysis, the mean urokinase dose used, or the 60-day patency rate.
Goodwin
S C
SC
Department of Radiological Sciences, UCLA School of Medicine, Center for the Health Sciences, BL-423, 10833 LeConte Avenue, Los Angeles, CA 90095-1721, USA.
Arora
L C
LC
Razavi
M K
MK
Sayre
J
J
McNamara
T O
TO
Yoon
C
C
D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000008:administration & dosage*; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D006435:Renal Dialysis; D015912:Thrombolytic Therapy / Q000379:methods*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D014654:Vascular Patency
D011138:Polytetrafluoroethylene; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator