Thrombolysis with i.v. recombinant human tissue-type plasminogen activator in patients with bypass graft occlusion: a good adjunctive therapeutic mode (preliminary and case reports).
METHODS
The authors report their experience with thrombolytic therapy in seven cases of graft thrombosis managed successfully with low-dose i.v. rt-TPA. In six patients the cause was an anatomical one and so, after the successful lysis, there was enough time to confirm a correct diagnosis and plan the "right" and "less extensive" surgical procedure, obviating it in one case with a "functional" cause of thrombosis.


RESULTS
No complication directly attributable to rt-TPA infusion occurred, and no systemic fibrinogenolysis was registered in any cases. Judging from this experience, i.v. rt-TPA appears safe and effective in patients with graft thrombosis, proving to be a good adjunctive therapeutic mode.


CONCLUSIONS
Further studies are needed do delineate more clearly safe indication and the validity of this method.
Agresta
F
F
Department of Surgery, Ospedale Civile, Vittorio Veneto, Treviso, Italy.
Michelet
I
I
Boni
V
V
Tonietto
G
G
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007511:Ischemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012449:Safety; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator