Two urokinase dose regimens in native arterial and graft occlusions: initial results of a prospective, randomized clinical trial.

Abstract

The effects of two urokinase (UK) dose regimens on lysis time, lytic success, primary clinical success, and frequency of complications of peripheral thrombolysis were compared. Seventy-two intraarterial UK infusions were performed by means of standard catheter-directed infusion techniques in 63 patients with symptomatic peripheral arterial or bypass graft occlusions. Patients were prospectively randomized to high-dose (250,000 U/h for 4 hours and then 125,000 U/h) or low-dose (50,000 U/h) regimens. The mean time to complete lysis was 20.8, 26.0, 16.5, and 18.2 hours for the high-dose artery, low-dose artery, high-dose graft, and low-dose graft groups, respectively (P was not significant). Respective mean infusion durations were 27.1, 35.4, 22.2, and 25.3 hours. Clinical success was achieved in 65%-85% of cases. The frequency of complications was equivalent between groups, except for a higher frequency of minor bleeding complications in the high-dose group. The two urokinase dose regimens studied were equally effective in enabling peripheral thrombolysis.

Intracoronary Fibrin-Specific Thrombolytic Infusion Facilitates Percutaneous Recanalization of Chronic Total Occlusion

“…Comparison with previous studies of lytic infusion. Previous studies have examined the use of urokinase infusion of chronic occlusions of recanalization of peripheral arteries (14), saphenous vein bypass grafts (15), and native coronary arteries (16,17). The infusion of fibrin-specific thrombolytic therapy in peripheral arterial occlusions for clot lysis has been reported at doses and durations similar to those used in Figure 2.…”

Endovascular treatment of acute limb ischemia due to thrombotic occlusion of the suprainguinal artery

“…To accelerate the dissolution and to shorten the treatment time, a high dose can be injected within the first few hours. In one study, a high dose (250,000 IU/hr for 4 hours followed by 125,000 IU/hr) and low dose (50,000 IU/hr) of urokinase injection were all reported to be similarly effective on a peripheral thrombus 13 so it is thought that the dosage can be determined depending on the clinical status of the patient and severity of the lesion.…”

Endovascular Management of Acute Total Occlusion of the Aorta

“…If outflow is occluded, the effects of the thrombolytic can be limited. Dosage and technique of urokinase infusion are various 12,13) . Considering the smaller body weight of Koreans, we administered a bolus of urokinase followed by a continous infusion in reduced doses.…”