Intraarterial thrombolysis of lower extremity occlusions: prospective, randomized comparison of forced periodic infusion and conventional slow continuous infusion
| Autor: | Joseph F. Polak, Samuel Z. Goldhaber, Krishna Kandarpa, Michael F. Meyerovitz, Magruder C. Donaldson, Anthony D. Whittemore, John E. Aruny, John A. Mannick, Paramjit S. Chopra |
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| Rok vydání: | 1993 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Ischemia Arterial Occlusive Diseases law.invention Bolus (medicine) Randomized controlled trial law Humans Infusions Intra-Arterial Medicine Thrombolytic Therapy Radiology Nuclear Medicine and imaging Prospective Studies Thrombus Aged Urokinase Leg business.industry Thrombolysis Middle Aged medicine.disease Urokinase-Type Plasminogen Activator Surgery Anesthesia Female business Complication Perfusion medicine.drug |
| Zdroj: | Radiology. 188:861-867 |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | A prospective randomized controlled trial compared forced infusion (FI) of urokinase (UK) with conventional slow continuous infusion (CI) in 25 patients with 25 acutely ischemic lower limbs. Demographics, ischemia categories, and infusion rates and doses were similar for both groups. A preliminary single-pass bolus of UK was injected into the thrombus in all patients with a pulsed-spray technique, and heparin was administered. UK was then infused with a CI pump (n = 13) or a prototype pulsed-spray pump (n = 12). The primary end point was patency, defined as at least 95% thrombolysis by volume, with brisk antegrade flow occurring within 4 hours. Eleven of the 12 patients (92%) who underwent FI and nine of the 13 (70%) who underwent CI had patency within 4 hours. However, 10 patients who underwent FI and nine who underwent CI had residual thrombi prolonging infusion. No significant differences between the two groups were apparent in speed of lysis, initial success rates, complication rates, or 30-day clinical outcome. Lytic therapy, however, was completed within 24 hours in 18 of 23 (78%) successfully treated patients (P = .01). |
| Databáze: | OpenAIRE |
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