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Contrast extravasation through Dacron grafts: a sequela of low-dose streptokinase therapy
Insights
Low-dose streptokinase treatment for thrombosed Dacron grafts caused contrast material leakage. This fibrinolytic activity likely dissolved fibrin within the graft, leading to the observed extravasation in patients.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Biomaterials Science
Background:
- Thrombosed Dacron grafts pose a significant clinical challenge.
- Transcatheter administration of fibrinolytic agents is an emerging treatment strategy.
Observation:
- Four patients with thrombosed Dacron grafts received local, low-dose streptokinase infusion.
- Post-infusion angiography demonstrated contrast material extravasation through graft interstices in all cases.
Findings:
- The knitted Dacron grafts were surgically placed 1 month to 6 years prior to treatment.
- Streptokinase's fibrinolytic activity is hypothesized to lyse fibrin within the graft interstices.
- This lysis resulted in the observed extravasation of contrast material.
Implications:
- This finding highlights a potential complication of using streptokinase for Dacron graft thrombosis.
- Further research is needed to understand the extent of graft integrity compromise.
- Alternative or modified fibrinolytic strategies may be required to mitigate this risk.
Abstract:
Local transcatheter administration of low-dose streptokinase for the treatment of thrombosed Dacron grafts was performed in four patients. Angiography after the infusion revealed extravasation of contrast material through the interstices of the graft. In each case the graft material was knitted Dacron, Surgically placed 1 month to 6 years before infusion with streptokinase. The fibrinolytic activity of streptokinase is likely responsible for lysis of the fibrin in the interstices of the graft with resultant extravasation of contrast material.