Document Detail

Prolonged urokinase infusion for chronic total native coronary occlusions: clinical, angiographic, and treatment observations.
MedLine Citation:
PMID:  7788687     Owner:  NLM     Status:  MEDLINE    
Prolonged intravascular infusion of urokinase has proven beneficial in reestablishing patency of chronically occluded peripheral arteries and saphenous vein grafts. This study was performed to assess the efficacy and safety of prolonged urokinase infusion as a prelude to angioplasty in chronically occluded native coronary arteries, that had failed standard angioplasty techniques. Twenty-five patients with objective evidence for ischemia in the distribution of a chronic coronary occlusion were referred for percutaneous intervention. Patients were assessed for any potential exclusions from lytic therapy. Urokinase infusion through both a SOS wire and a stable guiding catheter was continued at 100,000-240,000 units/hr for 8-25 hr; patients then underwent attempted balloon angioplasty. Mean duration of urokinase infusion was 20.6 +/- 7.7 hr (total dose 163,000 +/- 52,447 units/hr). Fibrinogen levels dropped slightly with this (300 +/- 129 to 203 +/- 81 mg/dl, P = 0.02). Angiography posturokinase showed improvement in 7 (28%) with regard to coronary flow (> or = 1 TIMI-grade). Angioplasty was successful in 13 (52%), with final angiographic result revealing thrombus in 5 (20%), or dissection 8 (32%). The infusions were well-tolerated with a low incidence of chest pain, 2 (8%) or ischemic ECG response, 2 (8%); myocardial infarction, 2 (8%); or significant bleeding 2 (8%). All patients survived the procedure, with a length-of-hospital stay = 5.1 +/- 4 days. Use of prolonged preangioplasty intracoronary urokinase infusion can be done safely with success in roughly one-half of patients with chronic total native coronary occlusions who have failed prior attempts at percutaneous intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
S C Ajluni; D Jones; F Zidar; S Puchrowicz; A Margulis; W W O'Neill; C L Grines
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  34     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-07-26     Completed Date:  1995-07-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  106-10; discussion 111     Citation Subset:  IM    
William Beaumont Hospital, Royal Oak, Michigan.
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MeSH Terms
Aneurysm, Dissecting / radiography
Angina Pectoris / drug therapy*,  radiography
Angioplasty, Transluminal, Percutaneous Coronary
Chronic Disease
Combined Modality Therapy
Coronary Aneurysm / radiography
Coronary Angiography*
Coronary Circulation / drug effects
Coronary Disease / drug therapy*,  radiography
Coronary Thrombosis / drug therapy,  radiography
Drug Administration Schedule
Electrocardiography / drug effects
Middle Aged
Myocardial Infarction / drug therapy*,  radiography
Thrombolytic Therapy*
Treatment Outcome
Urokinase-Type Plasminogen Activator / administration & dosage*
Reg. No./Substance:
EC Plasminogen Activator

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