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Sequestrated thrombolysis: comparative evaluation in vivo.

S Roy¹, F Laerum, F Brosstad

¹Institute for Surgical Research, National Hospital, Oslo, Norway.

Cardiovascular and Interventional Radiology

|May 5, 2000

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Transthrombic sequestrated thrombolysis, using concentrated recombinant tissue plasminogen activator (rt-PA), effectively reduced deep vein thrombosis (DVT) in a porcine model. This method shows promise for improving acute DVT treatment outcomes.

Area of Science:

Vascular Surgery
Thrombosis Research
Pharmacology

Background:

Thrombus lysis depends on local thrombolytic enzyme concentration.
Acute deep vein thrombosis (DVT) requires effective treatment strategies.

Purpose of the Study:

To evaluate if perithrombic sequestration of concentrated enzyme solutions accelerates thrombolysis in a porcine DVT model.
To compare sequestrated thrombolysis with conventional infusion methods.

Main Methods:

Deep vein thrombosis (DVT) was induced in porcine hind limbs.
Recombinant tissue plasminogen activator (rt-PA) was administered via conventional infusion (CI), proximal sequestrated thrombolysis (ST-P), or transthrombic sequestrated thrombolysis (ST-T).
Thrombus mass and residual thrombosis in venous tributaries were measured post-treatment.

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Main Results:

Transthrombic sequestrated thrombolysis (ST-T) normalized residual thrombus mass compared to controls (median RTI 0.50).
ST-T and ST-P showed significantly lower residual thrombosis in venous tributaries than CI (p=0.04).
No systemic fibrinogenolysis or significant differences in coagulation parameters were observed across groups.

Conclusions:

Transthrombic sequestrated thrombolysis demonstrates potential advantages over conventional selective infusion for acute DVT.
Further refinements are needed to establish ST-T as a viable alternative treatment for DVT.