Pharmacomechanical thrombolysis of experimental pulmonary emboli: Rapid low-dose intraembolic therapy

V. F. Tapson, P. A. Gurbel, L. A. Witty, K. S. Pieper, R. S. Stack

Research output: Contribution to journalArticlepeer-review

Abstract

We utilized low-dose intraembolic urokinase (UK) infusions in a canine model of experimental pulmonary embolism (PE) and compared the arteriographic extent of thrombolysis with three other treatment regimens. Group 1 animals (n=16) received the intraembolic UK infused directly into the PE offering the mechanical effect of the infusion combined with pharmacologic thrombolysis. In the group 2 animals (n=5), UK was delivered via a guide catheter placed proximal to the clot. Group 3 animals (n=6) were treated with a direct intraembolic saline solution infusion. Group 4 (n=7) received only intravenous heparin. The arteriographic extent of thrombolysis was graded 1+ to 3+. The extent of thrombolysis was 2.88+ in the group 1 animals and was significantly greater than in groups 2, 3, or 4 (p=0.003, 0.0005, and 0.0001, respectively). Fibrinogen levels did not significantly decrease with intraembolic treatment (p=0.07). Delivery of UK directly into emboli in an experimental canine PE model appears to elicit a combined mechanical and pharmacologic effect resulting in extensive thrombolysis.

Original languageEnglish (US)
Pages (from-to)1558-1562
Number of pages5
JournalCHEST
Volume106
Issue number5
DOIs
StatePublished - Jan 1 1994

Keywords

  • fibrinogenolysis
  • pulmonary embolism
  • thrombolytic therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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