Document Detail


Peripheral thrombolysis with tissue plasminogen activator. Results of two treatment regimens.
MedLine Citation:
PMID:  8048859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A S Ward; S K Andaz; S Bygrave
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  129     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-08-30     Completed Date:  1994-08-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  861-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, District Hospital, Basingstoke, England.
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MeSH Terms
Descriptor/Qualifier:
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:
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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