| Prolonged urokinase infusion for chronic total native coronary occlusions: clinical, angiographic, and treatment observations. | |
| | |
MedLine Citation:
|
PMID: 7788687 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
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) |
| | |
Authors:
|
S C Ajluni; D Jones; F Zidar; S Puchrowicz; A Margulis; W W O'Neill; C L Grines |
Related Documents
:
|
7782397 - Angioplasty in acute myocardial infarction. 8427177 - Complications associated with percutaneous placement and use of intraaortic balloon cou... 1451257 - How does angioplasty work? serial analysis of human iliac arteries using intravascular ... 14517917 - Distal protection in native coronary arteries during primary angioplasty in acute myoca... 495497 - Left bundle branch block: angiographic segmental wall motion abnormalities. 3779917 - Color doppler detection of multiple ventricular septal defects. |
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 |
Affiliation:
|
William Beaumont Hospital, Royal Oak, Michigan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged 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 Female Humans Male Middle Aged Myocardial Infarction / drug therapy*, radiography Thrombolytic Therapy* Treatment Outcome Urokinase-Type Plasminogen Activator / administration & dosage* |
| Chemical | |
Reg. No./Substance:
|
EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Antimicrobial susceptibilities of Shigella dysenteriae type 1 isolated in Zimbabwe--implications for...
Next Document: Transluminal extraction catheter for the treatment of diseased saphenous vein grafts: a multicenter ...