Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism

Autor: Julien Guillaumin, Teresa C DeFrancesco, Brian A Scansen, Rebecca Quinn, Megan Whelan, Rita Hanel, Isabelle Goy-Thollot, Isabelle Bublot, James B Robertson, John D Bonagura
Rok vydání: 2022
Předmět:
Zdroj: Journal of feline medicine and surgery. 24(12)
ISSN: 1532-2750
Popis: Objectives The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). Methods Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher’s exact, Student’s t- and Mann–Whitney–Wilcoxon tests. Results Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [ P = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups ( P Conclusions and relevance Survival and complication rates of acute FATE were not different with or without thrombolysis. High in-hospital mortality decreased the statistical power to detect a statistically significant difference between treatments with regard to our primary outcome.
Databáze: OpenAIRE