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Prolonged selective urokinase infusion in totally occluded coronary arteries and bypass grafts: two case reports
L McKeever1, J Hartmann, V Bufalino
1Section of Cardiology, Good Samaritan Hospital, Downers Grove, Illinois.
Catheterization and Cardiovascular Diagnosis
|January 1, 1988
Insights
This study presents a new method for dissolving blood clots in coronary arteries using urokinase infusion. This technique enables angioplasty on previously inaccessible lesions.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Thrombolytic Therapy
Background:
- Coronary artery disease and bypass graft occlusions often involve thrombus formation.
- Percutaneous coronary intervention (PCI) is a primary treatment modality.
- Accessing distal lesions through stenotic segments can be challenging.
Observation:
- A novel technique utilizing prolonged selective infusion of urokinase via an infusion wire was developed.
- This method facilitates passage of a steerable guide wire through obstructive thrombus and stenosis.
- The technique allows visualization and treatment of previously unseen distal lesions.
Findings:
- Successful thrombolysis in coronary arteries and bypass grafts was demonstrated.
- The infusion wire technique enabled crossing of complex stenotic lesions.
- Distal lesions, previously inaccessible, became amenable to angioplasty.
Implications:
- This technique offers a potential advancement in treating complex coronary occlusions.
- It may improve outcomes for patients with challenging coronary artery disease.
- Enhanced recanalization strategies could expand interventional cardiology's capabilities.
Abstract:
Reports are presented demonstrating a technique for dissolving thrombus in coronary arteries and bypass grafts by using prolonged selective infusion of urokinase via an infusion wire. This allows one to pass a steerable guide wire through the culprit stenosis and perform angioplasty on a distal lesion which could not be previously seen.