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Acute myocardial infarction complicating urokinase infusion for total saphenous vein graft occlusion
J C Blankenship1, T A Modesto, N P Madigan
1Department of Cardiology, Geisinger Medical Center, Danville, PA 17822.
Insights
Extended urokinase infusions effectively treat saphenous vein graft occlusions but carry risks. Myocardial infarction is a potential complication, suggesting careful consideration of this lytic therapy.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Saphenous vein graft (SVG) occlusion is a common issue post-coronary artery bypass grafting.
- Intra-graft thrombolysis using urokinase has shown promise in treating SVG occlusions.
Abstract:
Saphenous vein graft occlusions have been successfully treated with extended urokinase infusions. We report a case of myocardial infarction complicating this treatment. A review of reported cases suggests that this complication may not be uncommon. The optional drug, dose, and infusion technique for intra-graft lytic therapy has not been determined. The costs, risks, and difficulty of this technique may limit its application.