Abstract | PURPOSE: METHODS: An endovascular device that consisted of a tapered polytetrafluoroethylene graft attached within a self-expanding nitinol stent was delivered to bilateral common iliac veins in 20 pigs. Venous thrombosis occurred as a result of flow stasis created by the intrastent stenosis. Catheter-directed pulse-spray thrombolysis with urokinase (250,000 units) and heparin (5000 IU) was performed on one limb while the contralateral limb received control saline solution. Thrombolysis was performed in 1 hour (n = 4), 8 hours (n = 4), 3 days (n = 4), 7 days (n = 4), and 14 days (n = 4) after the stent-graft deployment. Venography and intravascular ultrasound were used to evaluate the efficacy of thrombolysis. Light microscopy was used for histologic analysis of the thrombus. RESULTS: Complete thrombolysis was achieved in groups with deep vein thrombosis that were younger than 1 day. Angioplasty of the tapered stent-grafts in the completely thrombolysed iliac vein was successful in restoring venous flow. The efficacy of thrombolysis in 3-day, 7-day, and 14-day groups was 86% +/- 7%, 73% +/- 13%, and 42% +/- 23%, respectively. The thrombolytic efficacy was enhanced to 92% +/- 16% and 86% +/- 18% (P <.05) in 3-day and 7-day groups, respectively, when doses of the pulse-spray thrombolysis were doubled. Increased dosages of the thrombolytic agent, however, did not significantly enhance the thrombus dissolution in the 14-day group. CONCLUSION:
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Authors | P H Lin, C Chen, S M Surowiec, B Conklin, R L Bush, A B Lumsden |
Journal | Journal of vascular surgery
(J Vasc Surg)
Vol. 33
Issue 3
Pg. 621-7
(Mar 2001)
ISSN: 0741-5214 [Print] United States |
PMID | 11241136
(Publication Type: Journal Article)
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Chemical References |
- Heparin
- Urokinase-Type Plasminogen Activator
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Topics |
- Animals
- Catheterization, Peripheral
- Disease Models, Animal
- Drug Therapy, Combination
- Heparin
(administration & dosage)
- Iliac Vein
(drug effects, pathology)
- Stents
- Swine
- Thrombolytic Therapy
- Thrombophlebitis
(drug therapy, pathology)
- Treatment Outcome
- Urokinase-Type Plasminogen Activator
(administration & dosage)
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