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Thrombolysis of occluded arterial bypass grafts

G A Gardiner1

  • 1Cardiovascular and Interventional Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.

Cardiovascular and Interventional Radiology
|January 1, 1988
PubMed

Insights

Direct intraarterial infusion of thrombolytic agents like streptokinase or urokinase effectively treated thrombosed grafts and arteries. Urokinase demonstrated a higher success rate than streptokinase with comparable complication risks.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Thrombosis of vascular grafts and native arteries presents a significant clinical challenge.
  • Intraarterial thrombolysis is a potential treatment modality for occlusive vascular disease.

Purpose of the Study:

  • To evaluate the efficacy and safety of direct intraarterial infusion of streptokinase and urokinase for treating thrombosed grafts and native arteries.
  • To compare the outcomes between different thrombolytic agents and between graft versus native artery occlusions.

Main Methods:

  • Seventy-eight patients with 87 thrombosed lesions (grafts or arteries) underwent direct intraarterial infusion of streptokinase or urokinase.
  • Success rates, complication rates, and graft patency after follow-up were assessed.

Main Results:

  • Initial success rates for thrombosed grafts (60%) and native arteries (63%) were similar.
  • Urokinase achieved a higher success rate (76%) compared to streptokinase (43%).
  • No significant differences in complication rates were observed between treatment groups or lesion types.

Conclusions:

  • Direct intraarterial infusion of streptokinase or urokinase is an effective treatment for thrombosed vascular grafts and arteries.
  • Urokinase appears to be more effective than streptokinase for this indication.
  • A significant proportion of treated grafts remained patent at long-term follow-up.

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