Locally applied recombinant plasmin results in effective thrombolysis in a porcine model of arteriovenous graft thrombosis.
J Vasc Interv Radiol
; 20(7): 951-8, 2009 Jul.
Article
em En
| MEDLINE
| ID: mdl-19481472
ABSTRACT
PURPOSE:
Arteriovenous (AV) graft thrombosis is a frequent complication in patients undergoing hemodialysis. Thrombolytic therapy with tissue plasminogen activator (TPA) is hampered by the risk of bleeding complications. Locally delivered plasmin may have similar thrombolytic efficacy with a superior safety profile, so herein it was compared with TPA in a porcine model of AV graft thrombosis. MATERIALS ANDMETHODS:
AV grafts were created bilaterally between the carotid artery and jugular vein. Graft thrombosis was induced by clamping the grafts for 1 hour. On day 3, one graft was treated with a 2-mL local recombinant plasmin injection (10 mg; n = 10) with the contralateral graft being infused with TPA (10 mg, n = 8) or saline solution (n = 2). Thrombolytic efficacy was assessed by weighing the residual clot and released clot fragments.RESULTS:
After saline solution injection, the mean residual clot weight in the graft was 618 mg. Local administration of TPA showed the least residual clot in the graft (69 mg +/- 26), with large clot particles reaching the venous outflow (241 mg +/- 23). Plasmin treatment significantly reduced the released clot mass versus TPA (52 mg +/- 23; P < .05), whereas residual clot weight was greater compared with TPA treatment (140 mg +/- 22; P < .05). Overall thrombolytic activity of plasmin (ie, residual clot plus released clot) was significantly better than that of TPA (193 mg +/- 25 vs 310 mg +/- 35; P < .05).CONCLUSIONS:
The thrombolytic efficacy of recombinant plasmin was shown to be superior to that of TPA in this study.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Trombose
/
Anastomose Cirúrgica
/
Terapia Trombolítica
/
Modelos Animais de Doenças
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Animals
/
Humans
Idioma:
En
Revista:
J Vasc Interv Radiol
Assunto da revista:
ANGIOLOGIA
/
RADIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Holanda