Meng Liu1,2, Fuxian Zhang1. 1. Department of Vascular Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China. 2. Department of Vascular Surgery, Tianjin Hospital, Tianjin 300211, China.
Abstract
BACKGROUND: Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Catheter-directed thrombolysis (CDT) is a preferred treatment for DVT patients. The aim of this study is to evaluate the thrombolytic effect of CDT with pro-urokinase (pro-UK) in different administration routes. METHODS: An inferior vena cava (IVC) model was induced in 36 New Zealand white rabbits by catheter injury and placement of IVC filter. The animals were divided into 6 groups with 6 rabbits in each group: group A: systemic thrombolysis with intravenous injection; group B: CDT with pump infusion; group C: CDT with pulse injection; group D: CDT with combination of pump infusion and pulse injection; group E: catheter-directed aspiration thrombectomy; group F: mechanical thrombectomy. The thrombolytic effects were evaluated by color Doppler ultrasound and blood measurement of D-dimer and fibrinogen. RESULTS: The minimum effective concentration of pro-UK solution was identified. Two groups (group A and B) did not achieve successful thrombolysis. Among all catheter-directed administration groups, the rabbit groups that received pro-UK therapy through catheter-directed thrombolytic pump infusion combined with pulse injection (group D) showed the best thrombolysis effect. In contrast, catheter-directed aspiration thrombectomy (group E) is effective but not safe. CONCLUSIONS: CDT with combination of pump infusion and pulse injection of pro-UK safely and significantly improves thrombolysis procedure in rabbits, suggesting potential benefits from the use of CDT in proximal DVT.
BACKGROUND: Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Catheter-directed thrombolysis (CDT) is a preferred treatment for DVT patients. The aim of this study is to evaluate the thrombolytic effect of CDT with pro-urokinase (pro-UK) in different administration routes. METHODS: An inferior vena cava (IVC) model was induced in 36 New Zealand white rabbits by catheter injury and placement of IVC filter. The animals were divided into 6 groups with 6 rabbits in each group: group A: systemic thrombolysis with intravenous injection; group B: CDT with pump infusion; group C: CDT with pulse injection; group D: CDT with combination of pump infusion and pulse injection; group E: catheter-directed aspiration thrombectomy; group F: mechanical thrombectomy. The thrombolytic effects were evaluated by color Doppler ultrasound and blood measurement of D-dimer and fibrinogen. RESULTS: The minimum effective concentration of pro-UK solution was identified. Two groups (group A and B) did not achieve successful thrombolysis. Among all catheter-directed administration groups, the rabbit groups that received pro-UK therapy through catheter-directed thrombolytic pump infusion combined with pulse injection (group D) showed the best thrombolysis effect. In contrast, catheter-directed aspiration thrombectomy (group E) is effective but not safe. CONCLUSIONS: CDT with combination of pump infusion and pulse injection of pro-UK safely and significantly improves thrombolysis procedure in rabbits, suggesting potential benefits from the use of CDT in proximal DVT.
Entities:
Keywords:
Deep venous thrombosis (DVT); catheter-directed thrombolysis (CDT); pro-urokinase (pro-UK)
Authors: Julian Prell; Jens Rachinger; Robert Smaczny; Bettina-Maria Taute; Stefan Rampp; Joerg Illert; Gershom Koman; Christian Marquart; Alexandra Rachinger; Sebastian Simmermacher; Alex Alfieri; Christian Scheller; Christian Strauss Journal: J Neurosurg Date: 2013-08-06 Impact factor: 5.115