Document Detail


Experimental treatment of thrombotic vascular occlusion.
MedLine Citation:
PMID:  1895868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The role of laser energy in the treatment of thrombotic vascular occlusion was evaluated in two sets of experiments. First, 10 polytetrafluoroethylene grafts were used to replace segments of the superficial femoral arteries in dogs and were thrombosed by distal ligation. Occlusion was maintained for one hour, or for 7, 14, 21, and 28 days in each of two grafts. Patency was restored in all 10 grafts without perforation or anastomotic disruption using a 2 mm hot tip probe powered by an Argon laser. However, increased organization of thrombus related to the duration of occlusion lead to decreased laser channel diameters, and 75% of the 28 day thrombus remained in the graft after recanalization. The second experiments tested the added benefit of thrombolytic infusion following laser recanalization. Bilateral external iliac artery thrombosis was induced in dogs by operative vessel isolation, de-endothelialization, and thrombin injection. At 7 days the efficacy of laser-assisted thrombolysis (LAT) versus enzymatic thrombolysis (ET) alone was compared. Eight vessels underwent ET by urokinase (4000 I.U./min.); 14 vessels were laser recanalized prior to thrombolytic infusion. LAT was performed from a carotid artery approach in 8 vessels (antegrade) and from a femoral artery in 6 vessels (retrograde). In contrast to studies using the hot tip alone, both ET and LAT accomplished complete thrombus removal. However, LAT lead to significant iliac arterial flow in 9 +/- 8 min. (antegrade) and 25 +/- 8 min. (retrograde) while ET required 109 +/- 47 min (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J D Labs; P L Caslowitz; R I White; J H Anderson; G M Williams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lasers in surgery and medicine     Volume:  11     ISSN:  0196-8092     ISO Abbreviation:  Lasers Surg Med     Publication Date:  1991  
Date Detail:
Created Date:  1991-10-24     Completed Date:  1991-10-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8007168     Medline TA:  Lasers Surg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  363-71     Citation Subset:  IM    
Affiliation:
Department of Surgery, Johns Hopkins Hospital, Baltimore, MD 21205.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Vessel Prosthesis
Catheterization, Peripheral
Combined Modality Therapy
Dogs
Femoral Artery / surgery
Follow-Up Studies
Graft Occlusion, Vascular / therapy
Iliac Artery
Laser Therapy*
Polytetrafluoroethylene
Regional Blood Flow
Safety
Thrombolytic Therapy
Thrombosis / pathology,  therapy*
Time Factors
Urokinase-Type Plasminogen Activator / administration & dosage,  therapeutic use
Vascular Patency
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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