Treatment of acute vascular occlusions with intra-arterial urokinase
| Autor: | Victor Parsonnet, Robert J. Goldenkranz, Debra Creighton, Bruce J. Brener, Donald K. Brief, Richard Shoenfeld, Jerome Nozick, Jan Huston, Pedro Cordero, U.R. Krishnan, David Eisenbud, Andrew C. Novick, Joseph Alpert |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Constriction Pathologic Constriction Graft occlusion Intra arterial Medicine Humans Infusions Intra-Arterial Thrombolytic Therapy Vascular Diseases Retrospective Studies Urokinase business.industry Graft Occlusion Vascular Retrospective cohort study General Medicine Middle Aged Urokinase-Type Plasminogen Activator Surgery Clot lysis Acute Disease Female business medicine.drug |
| Zdroj: | American journal of surgery. 160(2) |
| ISSN: | 0002-9610 |
| Popis: | This study reviewed 57 patients with 71 vascular occlusions treated with urokinase from 1985 to 1988. Of these patients, 89% were candidates for urgent surgery. Total clot lysis was achieved in 73% of cases. The success rate rose with increasing experience (p less than 0.05), and recent occlusions had more favorable outcomes than older ones (p less than 0.05). The length and type of occluded conduit (graft or vessel), age, sex, other medical conditions, and concurrent use of heparin had no influence on success. Of 18 cases successfully lysed and not subjected to any adjunctive therapy directed at the cause of occlusion, 9 (50%) reoccluded within 1 to 88 days (mean: 25 days). Cases successfully treated with thrombolysis and surgery or dilation of the causative stenosis had poor 1-year patencies: 17%, 20%, and 55% for vein grafts, prosthetic grafts, and native arteries, respectively. With additional urokinase treatments, surgical operations, and percutaneous procedures, 1-year patencies were 22%, 45%, and 65%, respectively. |
| Databáze: | OpenAIRE |
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