PMID: 2108854Apr 1, 1990Paper

A new short infusion dosage regimen of recombinant tissue plasminogen activator in patients with venous thromboembolic disease

Chest
M N LevineJ Hirsh

Abstract

Although recombinant tissue-type plasminogen activator (rt-PA) has the potential to induce thrombolysis without producing a generalized coagulopathy, the dosage regimens in present use induce a plasma fibrinolytic state and are associated with bleeding. Animal experiments have demonstrated that rt-PA produces continuing thrombolysis after it is cleared from the circulation and that thrombolysis is increased and bleeding is reduced when rt-PA is administered over a short time period. To determine whether a short course regimen of rt-PA has potential in man, we gave a bolus injection of rt-PA (0.6 mg/kg) concurrently with heparin to five patients with venous thromboembolism. Three patients with angiographically proven pulmonary embolism had marked improvement of the perfusion defects when lung scans were repeated 24 h after rt-PA administration. In one of two patients with thrombosis of the deep veins of the upper extremity the venographic defect resolved completely. In three of four patients there was a mild decrease in fibrinogen and a moderate decrease in alpha 2-antiplasmin levels. There was no excessive bleeding. These results suggest that a bolus injection regimen of rt-PA has considerable potential in the treatment of thro...Continue Reading

References

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Citations

Mar 9, 2005·Der Anaesthesist·F SpöhrA Walther
Nov 1, 1987·Journal of the American College of Cardiology·S Z GoldhaberJ Loscalzo
Jul 8, 2003·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahiro OtaTakeshi Nakano
Jul 25, 1991·The American Journal of Cardiology·B TranchesiM Verstraete
Oct 12, 2000·Journal of the American College of Cardiology·J SchweizerA Graf
Sep 21, 2000·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·M GrünewaldH Osterhues
Jan 1, 1993·The Journal of Emergency Medicine·S H ThomasE J Allison

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