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Local thrombolysis in the treatment of thrombosed arteries, bypass grafts, and arteriovenous fistulas.

Abstract：

:We reviewed the results, systemic effects, and complications associated with the selective infusion of low-dose streptokinase in 151 patients. Successful thrombus lysis was achieved in 78% of atherosclerotic thrombotic occlusions less than 30 days old, in 81% of post-procedural occlusions less than 14 days old, and in 87% of patients with thrombosed arteriovenous fistulas no more than 4 days old. During the first 12 hours of treatment 81% to 84% of patients had greater than 50% decrease in plasma fibrinogen levels and 100% showed the same decline after 24 hours of treatment. The thrombin time was prolonged to at least 1 1/2 times the control thrombin time in 33% to 42% of patients measured at 4 hours of therapy and in 93% to 97% of patients measured at 24 hours of treatment. Fifteen patients (9.9%) had major complications. Eleven of these had hemorrhagic complications, two had significant distal emboli, one had a thrombosed brachial artery, and one had a false aneurysm at the catheter entry site. We have found that selective low-dose streptokinase is effective in the treatment of acute and chronic thrombotic occlusions and is a useful adjuvant to vascular reconstruction or percutaneous transluminal angioplasty. Although the local infusion dose is substantially lower than the usual systemic dose, a systemic lytic effect was seen in all patients. Hemorrhagic complications occurred despite customary precautions.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Graor RA,Risius B,Denny KM,Young JR,Beven EG,Hertzer NR,Ruschhaupt WF 3rd,O'Hara PJ,Geisinger MA,Zelch MG

doi

10.1067/mva.1985.avs0020406

subject

Has Abstract

pub_date

1985-05-01 00:00:00

pages

406-14

issue

3

eissn

0741-5214

issn

1097-6809

pii

0741-5214(85)90093-X

journal_volume

2

pub_type

杂志文章

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