Complications Associated with the Use of Urokinase and Recombinant Tissue Plasminogen Activator for Catheter-directed Peripheral Arterial and Venous Thrombolysis

摘要: PURPOSE Catheter-directed thrombolytic dissolution of peripheral arterial and venous thrombus is in widespread use, yet the frequency nature associated complications remain ill defined. In an effort to better characterize with urokinase (UK) recombinant tissue plasminogen activator (rt-PA), clinical course patients treated for lower extremity vascular occlusions at a single institution was reviewed. MATERIALS AND METHODS Over 9-year period, 653 consecutive were (527 patients) or (126 catheter-directed UK (483 patients), rt-PA (144 both (26 patients). Decisions regarding choice agent made by clinician. In-hospital subcategorized into hemorrhagic nonhemorrhagic events rate intracranial hemorrhage specifically tabulated. RESULTS There no significant differences demographics presentation either rt-PA. Bleeding occurred less often (insertion site hematoma 21.9% vs 43.8%, P = .004, 0.6% 2.8%, .031). Cardiopulmonary necessitating transfer intensive care unit more frequently (4.9% 1.5%, .015). The risk mortality not statistically different between (2.7% 6.2%, .221). CONCLUSIONS Thrombolysis appears safer than rt-PA, incidence complications. It possible that this finding related differential dosing regimens intrinsic pharmacologic agents. observations retrospective analysis require confirmation prospective, randomized evaluation.