当前位置： SCI文献检索 > CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY期刊下所有文献 > Transcatheter intracavitary fibrinolysis of loculated pleural effusions: experience in 102 patients.

Transcatheter intracavitary fibrinolysis of loculated pleural effusions: experience in 102 patients.

Abstract：

PURPOSE:To assess the efficacy of intrapleural urokinase instillation through small-caliber catheters for the treatment of loculate and/or septate effusions. METHODS:We inserted small-caliber catheters (8.2 Fr) in 102 patients with septate and/or loculate pleural effusions using ultrasonographic guidance. Urokinase (100,000 IU/2 hr, 3 times a day) was instilled through the catheter until the effusion resolved and D-dimer levels were <500 ng/ml. Patients were enrolled regardless of the etiology of the pleural effusion provided there were no contraindications for the use of urokinase. D-dimer levels were determined before and after treatment. Follow-up was performed by chest radiograph and sonography at 1 day, 7 days, and every 30 days thereafter for 6 months. RESULTS:Successful catheter placement was achieved in all cases. The mean time catheters stayed in place was 5.7 days and the mean dose of drug instilled was 690,000 IU. Pleural effusion drainage was complete at the first assessment in all patients. Failure of the treatment, with recurrent effusion at 30 days, occurred in six patients (5.8%). Complete resolution without sequelae was observed in 19 patients (19.6%). In 75 cases (73.5%) resolution was partial, with pleural thickening (>2 mm). Two patients died from unrelated causes within 30 days after catheter placement. Complications were seen in 13 patients (12.74%): hydropneumothorax, nine cases (8.82%); infection of the puncture point, three cases (2.94%); and adverse reaction, one case (0.98%). No further treatment was required. CONCLUSION:The use of intrapleural fibrinolytic agents delivered through small-caliber catheters for the treatment of loculate and/or septate pleural effusion is a simple, effective, minimally invasive and inexpensive procedure that can prevent sequelae and shorten drainage time.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

De Gregorio MA,Ruiz C,Alfonso ER,Fernández JA,Medrano J,Ariño I

doi

10.1007/s002709900345

subject

Has Abstract

pub_date

1999-03-01 00:00:00

pages

114-8

issue

eissn

0174-1551

issn

1432-086X

journal_volume

pub_type

杂志文章

在线工具

Transcatheter intracavitary fibrinolysis of loculated pleural effusions: experience in 102 patients.