| Peripheral thrombolysis with tissue plasminogen activator. Results of two treatment regimens. | |
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MedLine Citation:
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PMID: 8048859 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to document the response to tissue plasminogen activator given as either a low-dose intra-arterial infusion or a bolus infusion in patients with peripheral arterial or bypass graft occlusion. DESIGN: Fifty thrombolytic procedures were carried out in 45 patients with a recent occlusion of a peripheral artery (41) or bypass graft (nine). A continuous infusion of 1.0 mg/h of tissue plasminogen activator was used in 27 patients (group A), while 23 patients were given a 20-mg bolus followed by an infusion of 1.0 mg/h (group B). Patients in the two groups were followed up for 12.1 +/- 9.3 months and 11.1 +/- 9.1 months, respectively. RESULTS: In group A, the angiographic lysis rate was 74% and clinical success rate was 67%. In group B, the comparable rates were 70% and 48%. Lysis was quicker when a bolus infusion was used, the mean lysis time being 14.4 +/- 7.9 hours compared with 26.7 +/- 9.4 hours following infusion alone (P = .0005). There was one instance of major hemorrhage in group A and eight in group B (P = .0022), including two patients with cerebral hemorrhage, one of whom died. CONCLUSION: Low-dose tissue plasminogen activator infusion is safe and reasonably effective, although a long treatment time is required. A bolus infusion regimen speeds lysis but is attended by a high incidence of serious hemorrhage. |
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Authors:
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A S Ward; S K Andaz; S Bygrave |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 129 ISSN: 0004-0010 ISO Abbreviation: Arch Surg Publication Date: 1994 Aug |
Date Detail:
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Created Date: 1994-08-30 Completed Date: 1994-08-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 861-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, District Hospital, Basingstoke, England. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Female Graft Occlusion, Vascular / drug therapy* Humans Infusions, Intra-Arterial Male Middle Aged Peripheral Vascular Diseases / drug therapy* Thrombolytic Therapy / adverse effects, methods* Tissue Plasminogen Activator / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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