| Author/Editor | Poredoš, Pavel; Videčnik, Viktor | |
| Title | LYS-plasminogen shortens the duration of local thrombolytic treatment of peripheral arterial occlusions - a randomized controlled trial | |
| Type | članek | |
| Source | Wien Klin Wochenschr | |
| Vol. and No. | Letnik 111, št. 1 | |
| Publication year | 1999 | |
| Volume | str. 21-5 | |
| Language | eng | |
| Abstract | Local thrombolytic treatment of peripheral arterial occlusions, which has been accepted as a therapeutic alternative to surgical treatment, is not always successful. One of the reasons for unsuccessful thrombolytic treatment might be a low concentration of plasminogen in the thrombus or insufficient activation of the thrombolytic system. Therefore the purpose of this study was to determine whether the success of local treatment of peripheral arterial occlusions of lower extremities with streptokinase could be improved by enriching the thrombus with exogenous plasminogen and furthermore, if the therapeutic success depends on a systemic fibrinolytic effect. In a prospective randomized study two groups of patients with acute and subacute arterial occlusions of the lower limbs (Stage III, IV) were treated with a continuous infusion of local low dose of streptokinase (SK). The first group (45 patients, mean age 73 years) was treated with SK only (3750 IU/hour) (SK group). While the patients in the second group (43 patients, mean age 72 years) received exogenous lysplasminogen (7.5 mg) before application of SK in thrombi (SK-Plg group). The treatment was successful in 69% (31 out of 45 patients) of the SK group and in 77% (33 out of 43 patients) of the SK-Plg group. Although lysis of thrombi was observed more frequently in the SK-Plg group than in the SK-group, the clinical outcome was comparable between groups. In successfully treated patients from the shorter than in the SK group (33+-8 hr vs. 53+-11 hr, p < 0.01 ). A significant decrease of fibrinogen concentration as an indicator of activation of fibrinolysis was not observed in the majority of treated patients. (Abstracts truncated at 2000 characters). | |
| Descriptors | ARTERIAL OCCLUSIVE DISEASES PLASMINOGEN THROMBOLYTIC THERAPY PEPTIDE FRAGMENTS MIDDLE AGE AGED ISCHEMIA STREPTOKINASE LEG TIME FACTORS TREATMENT OUTCOME |