Recombinant human tissue-type plasminogen activator is an effective agent for thrombolysis of peripheral arteries and bypass grafts: preliminary report

Journal of Vascular Surgery
W C KrupskiJ H Rapp

Abstract

The efficacy, safety, and effects on hemostasis and coagulation of two doses of human tissue-type plasminogen activator in patients with acute and subacute peripheral arterial occlusion were compared. Seven patients with lower extremity ischemia and one patient with upper extremity ischemia had peripheral arterial thromboses (five arteries, three grafts) confirmed by clinical history, physical examination, and angiography. The duration of occlusion ranged from 31 hours to 30 days (mean 11.9 days). Tissue-type plasminogen activator was infused via a catheter directly into the thrombus at a randomly assigned dose of 0.05 mg/kg/hr (n = 4) or 0.025 mg/kg/hr (n = 4). Thrombolysis was complete in seven patients and partial in one. Duration of infusion ranged from 1 hour to 21 hours (mean 7.4 hours). The low dose required a longer infusion than did the high dose, but they were both successful in achieving thrombolysis. The one patient with partial thrombolysis had abrupt discontinuation of infusion when extravasation through a recently endarterectomized femoral artery developed. Otherwise there were no significant complications from tissue-type plasminogen activator therapy. Secondary procedures to correct underlying arterial disease ...Continue Reading

Citations

Dec 5, 2003·Journal of Vascular and Interventional Radiology : JVIR·Mahmood K RazaviLawrence V Hofmann
Jan 8, 2004·Journal of Vascular and Interventional Radiology : JVIR·Mahmood K RazaviLawrence V Hofmann
Jul 1, 1995·Journal of Vascular and Interventional Radiology : JVIR·C J BeroG G Nicholas
Jan 15, 2002·Journal of Vascular and Interventional Radiology : JVIR·Aravind ArepallyBruce Perler
Sep 30, 2003·Journal of Vascular and Interventional Radiology : JVIR·UNKNOWN Working Party on Thrombolysis in the Management of Limb Ischemia
Nov 11, 1991·Cardiovascular and Interventional Radiology·S L KaufmanW J Casarella

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