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Dialysis access graft thrombolysis: randomized study of pulse-spray versus continuous urokinase infusion
S C Goodwin1, L C Arora, M K Razavi
1Department of Radiological Sciences, UCLA School of Medicine, Center for the Health Sciences, BL-423, 10833 LeConte Avenue, Los Angeles, CA 90095-1721, USA.
Purpose:
To compare pulse-spray to continuous-infusion thrombolysis with high-dose urokinase in thrombosed dialysis access grafts.
Methods:
A prospective randomized controlled trial was performed. From August 1992 to September 1993, 30 thrombosed polytetrafluoroethylene (PTFE) grafts in 24 patients were included, 15 grafts in each group. The success of thrombolysis, mean time to thrombolysis, mean urokinase dose, and 60-day patency rate were evaluated.
Results:
In the pulse-spray group, the mean time to thrombolysis was 72 min with a mean urokinase dose of 560,000 U. The 60-day patency rate was 71%. In the continuous-infusion group, the mean infusion time to thrombolysis was 55 min with a mean dose of 479,000 U. The 60-day patency rate was 73%.
Conclusion:
No statistically significant difference was found between the two techniques in the mean time to thrombolysis, the mean urokinase dose used, or the 60-day patency rate.