Efficacy of Tissue Plasminogen Activator and Urokinase in a Canine Model of Prosthetic Graft Thrombosis

Gr, Curl; Ja, Jakubowski; Dc, Nabseth; Hl, Bush

doi:10.1001/archsurg.1986.01400070048010

Arch Surg

1986

DOI: 10.1001/archsurg.1986.01400070048010

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Efficacy of Tissue Plasminogen Activator and Urokinase in a Canine Model of Prosthetic Graft Thrombosis

Curl Gr¹,

Jakubowski Ja²,

Nabseth Dc³

et al.

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1988

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Cited by 10 publications

References 28 publications

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Local thrombolytic therapy of acute peripheral arterial ischaemia with tissue plasminogen activator: A dose-ranging study

Earnshaw

Westby

Gregson

et al. 1988

British Journal of Surgery

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Low-dose streptokinase has been established as an alternative to surgery in selected patients with acute peripheral arterial ischaemia. Tissue plasminogen activator (t-PA) is responsible for normal plasma fibrinolytic activity and has recently become available for clinical use owing to recombinant DNA technology. It has the theoretical advantage of fibrin specificity, which may result in enhanced thrombolytic effects with greater safety. Twenty-three patients with recent lower limb arterial occlusions received t-PA over a tenfold range of concentrations and five patients received low-dose streptokinase. One month after treatment with t-PA or streptokinase 19 (68 per cent) patients had limb salvage, five (18 per cent) had required amputations and four (14 per cent) had died. Systemic fibrinolytic effects were variable but basically dose related. Haemorrhage occurred most frequently at the highest t-PA concentration and was major in four (17 per cent) cases, including a fatal stroke. Plasma fibrinogen concentration fell below 1.2 gl-1 in five (22 per cent) patients who received t-PA and was found to be a significant risk factor for haemorrhage, t-PA was an effective thrombolytic agent at all concentrations studied. The dose currently used in clinical studies at this institution is 0.5 mg h-1.

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Local thrombolytic therapy of acute peripheral arterial ischaemia with tissue plasminogen activator: A dose-ranging study

Earnshaw

Westby

Gregson

et al. 1988

British Journal of Surgery

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Experimental treatment of thrombotic vascular occlusion

et al. 1991

Lasers Surg Med

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The role of laser energy in the treatment of thrombotic vascular occlusion was evaluated in two sets of experiments. First, 10 polytetrafluoroethylene grafts were used to replace segments of the superficial femoral arteries in dogs and were thrombosed by distal ligation. Occlusion was maintained for one hour, or for 7, 14, 21, and 28 days in each of two grafts. Patency was restored in all 10 grafts without perforation or anastomotic disruption using a 2 mm hot tip probe powered by an Argon laser. However, increased organization of thrombus related to the duration of occlusion lead to decreased laser channel diameters, and 75% of the 28 day thrombus remained in the graft after recanalization. The second experiments tested the added benefit of thrombolytic infusion following laser recanalization. Bilateral external iliac artery thrombosis was induced in dogs by operative vessel isolation, de-endothelialization, and thrombin injection. At 7 days the efficacy of laser-assisted thrombolysis (LAT) versus enzymatic thrombolysis (ET) alone was compared. Eight vessels underwent ET by urokinase (4000 I.U./min.); 14 vessels were laser recanalized prior to thrombolytic infusion. LAT was performed from a carotid artery approach in 8 vessels (antegrade) and from a femoral artery in 6 vessels (retrograde). In contrast to studies using the hot tip alone, both ET and LAT accomplished complete thrombus removal. However, LAT lead to significant iliac arterial flow in 9 +/- 8 min. (antegrade) and 25 +/- 8 min. (retrograde) while ET required 109 +/- 47 min (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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Thrombus age and tissue plasminogen activator mediated thrombolysis in rats

Loren¹,

Frade²,

Torrado³

et al. 1989

Thrombosis Research

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Efficacy of Tissue Plasminogen Activator and Urokinase in a Canine Model of Prosthetic Graft Thrombosis

Cited by 10 publications

References 28 publications

Local thrombolytic therapy of acute peripheral arterial ischaemia with tissue plasminogen activator: A dose-ranging study

Local thrombolytic therapy of acute peripheral arterial ischaemia with tissue plasminogen activator: A dose-ranging study

Experimental treatment of thrombotic vascular occlusion

Thrombus age and tissue plasminogen activator mediated thrombolysis in rats

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