Document Detail


Transcatheter regional urokinase therapy in the management of inferior vena cava thrombosis.
MedLine Citation:
PMID:  9840035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study the efficacy of local infusion of urokinase (UK) in the treatment of symptomatic inferior vena cava (IVC) thrombosis. MATERIALS AND METHODS: Eight patients (five men and three women) who ranged in age from 19 years to 75 years (mean, 56 years) with symptomatic IVC thrombosis underwent local catheter-directed infusion of UK with use of up to three access sites. Infrarenal IVC thrombus and iliac vein thrombus was identified in all patients. Four patients had extension of thrombus proximal to the renal veins. Seven of eight patients had at least one risk factor for IVC thrombosis: hypercoagulable state (n = 3), IVC filter (n = 3), malignancy (n = 2), recent surgery (n = 2), and oral contraceptive use (n = 1). No serious procedure-related complications were encountered, although one patient died 5 days after UK therapy of pulmonary failure due to advanced lung cancer. UK was infused for an average of 79 hours (range, 24-140 hours) and a mean total dose of 7.4 million U of UK (range, 2.9-14.4 million U). Adjunctive balloon angioplasty was performed in three patients. No vascular stents were placed. Clinical and/or radiographic follow-up was obtained in all eight patients. RESULTS: Thrombolysis was successful in seven of eight (88%) IVCs with no or minimal residual thrombus. The remaining seven patients had no lower extremity swelling 2-24 months (mean, 11 months) after the procedure. Three of seven patients had computed tomographic or venographic follow-up (mean, 9 months; range, 1.5-15 months), demonstrating unchanged or improved IVC patency. CONCLUSIONS: Transcatheter regional infusion of UK for re-establishing venous patency in acute IVC thrombosis appears to be effective with good short-term and mid-term clinical benefit.
Authors:
J F Angle; A H Matsumoto; M Al Shammari; K D Hagspiel; D J Spinosa; J E Humphries
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  9     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:    1998 Nov-Dec
Date Detail:
Created Date:  1999-01-22     Completed Date:  1999-01-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  917-25     Citation Subset:  IM    
Affiliation:
University of Virginia, Health Sciences Center, Charlottesville 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon
Breast Neoplasms / complications
Cause of Death
Contraceptives, Oral / therapeutic use
Female
Follow-Up Studies
Humans
Iliac Vein
Infusions, Intravenous
Lung Neoplasms / complications
Male
Middle Aged
Phlebography
Plasminogen Activators / administration & dosage,  therapeutic use*
Postoperative Complications
Renal Veins
Respiratory Insufficiency / etiology
Risk Factors
Thrombolytic Therapy*
Thrombophilia / complications
Tomography, X-Ray Computed
Urokinase-Type Plasminogen Activator / administration & dosage,  therapeutic use*
Vascular Patency
Vena Cava Filters
Vena Cava, Inferior* / radiography
Venous Thrombosis / drug therapy*,  radiography
Chemical
Reg. No./Substance:
0/Contraceptives, Oral; EC 3.4.21.-/Plasminogen Activators; 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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