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Related Experiment Videos

Intraoperative fibrinolytic therapy: experimental evaluation.

W J Quiñones-Baldrich, S Ziomek, T C Henderson

    Journal of Vascular Surgery
    |September 1, 1986
    PubMed
    Summary
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    Intraoperative fibrinolytic therapy using streptokinase is safe and effective when combined with catheter embolectomy for acute arterial occlusions. This adjunctive treatment significantly improved outcomes in canine models, warranting human trials.

    Area of Science:

    • Vascular Surgery
    • Interventional Radiology
    • Thrombolytic Therapy

    Background:

    • Acute arterial occlusions pose significant clinical challenges.
    • Fibrinolytic agents delivered via percutaneous intra-arterial infusion offer an alternative to surgical embolectomy.
    • Combining fibrinolytic therapy with embolectomy may enhance treatment efficacy.

    Purpose of the Study:

    • To evaluate the safety and efficacy of intraoperative fibrinolytic therapy as an adjunct to catheter embolectomy.
    • To compare outcomes of catheter embolectomy alone versus combined therapy in a canine model of acute arterial occlusion.

    Main Methods:

    • Forty canine hind limbs were subjected to induced thrombus formation and subsequent embolectomy after 24 hours.
    • Experimental groups received intra-arterial infusions of streptokinase (SK) with or without heparin, or saline (control), over 30 or 60 minutes.

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  • Arteriograms and blood flow measurements were assessed before and after intervention.

    • Main Results:

    • Angiographic improvement was observed in 20% of control limbs versus 100% with SK plus heparin and 80% with SK alone (p<0.01).
    • A trend towards increased blood flow was noted in experimental groups.
    • No intraoperative or significant postoperative bleeding complications occurred during the 36-hour observation period.

    Conclusions:

    • Intraoperative fibrinolytic therapy, particularly with streptokinase, is a safe and effective adjunct to thromboembolectomy in a canine model.
    • The combination therapy demonstrated superior results compared to embolectomy alone.
    • Further investigation in human clinical trials is recommended to translate these findings.