| Ultrasound-accelerated thrombolysis in arterial and venous peripheral occlusions: fibrinogen level effects. | |
| | |
MedLine Citation:
|
PMID: 20656221 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: This study retrospectively assesses whether significantly accelerating thrombolysis with ultrasound affects fibrinogen levels in the treatment of peripheral arterial occlusions. MATERIALS AND METHODS: Between December 2005 and August 2007, 38 limbs in 38 patients (17 women; mean age, 60.5 +/- 19.7 years; age range, 17-94 years) were treated with ultrasound-accelerated thrombolysis for peripheral arterial occlusion (PAO) and deep vein thrombosis (DVT), with serum fibrinogen levels measured at baseline and every 24 hours. All occlusions were treated with alteplase (0.5-1.0 mg/h). RESULTS: Complete or partial lysis was achieved in 92.1% of patients. All patients received thrombolytic therapy with mean infusion time of 42.3 hours (range, 20-96 hours). As part of standard clinical practice, patients were not assessed angiographically overnight. Mean total alteplase dose was 40.6 mg (range, 18-96 mg). Across all patients, the fibrinogen level at the end of infusion decreased by an average of 18.5% from baseline, and no patient exhibited a fibrinogen level < 100 mg/dL during treatment. Fibrinogen depletion was more pronounced among patients with venous occlusions (26.4% from baseline) than those with arterial occlusions (15.8% from baseline). No major hemorrhagic complications occurred. One patient (2.6%) experienced a minor bleeding event at the access site, and use of thrombolytics was discontinued; and one patient with a chronic arterial occlusion and underlying coronary disease who did not respond to thrombolytic therapy, experienced an acute myocardial infarction. Of documented 30-day clinical outcomes in 20 patients, 80.0% remained patent at 30 days. CONCLUSIONS: Ultrasound-accelerated thrombolysis for the treatment of PAO and DVT is associated with a very low complication rate and nominal fibrinogen depletion. |
| | |
Authors:
|
Rodney D Raabe |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of vascular and interventional radiology : JVIR Volume: 21 ISSN: 1535-7732 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-07-26 Completed Date: 2010-11-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1165-72 Citation Subset: IM |
Copyright Information:
|
Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Radiology, Sacred Heart Medical Center, 101 West Eighth Avenue, PO Box 2555, Spokane, WA 99220-2555, USA. rraabe@inland-imaging.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Arterial Occlusive Diseases / blood, drug therapy, radiography, therapy* Biological Markers / blood Combined Modality Therapy Down-Regulation Drug Administration Schedule Female Fibrinogen / metabolism* Fibrinolytic Agents / administration & dosage*, adverse effects Humans Infusions, Parenteral Male Middle Aged Peripheral Vascular Diseases / blood, drug therapy, radiography, therapy* Retrospective Studies Thrombolytic Therapy* / adverse effects Time Factors Tissue Plasminogen Activator / administration & dosage*, adverse effects Treatment Outcome Ultrasonic Therapy* / adverse effects Vascular Patency Venous Thrombosis / blood, drug therapy, radiography, therapy* Washington Young Adult |
| Chemical | |
Reg. No./Substance:
|
0/Biological Markers; 0/Fibrinolytic Agents; 9001-32-5/Fibrinogen; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: We Are IR.
Next Document: The Effectiveness of Locoregional Therapies versus Supportive Care in Maintaining Survival within th...