Regional infusion of urokinase into occluded lower-extremity bypass grafts: long-term clinical results

• Published in: Radiology Vol. 172; no. 1; p. 83
• Main Authors: Durham, J D, Geller, S C, Abbott, W M, Shapiro, H, Waltman, A C, Walker, T G, Brewster, D C, Athanasoulis, C A
• Format: Journal Article
• Language: English
• Published: United States 01-07-1989
• Subjects: Female; Graft Occlusion, Vascular - drug therapy; Graft Occlusion, Vascular - physiopathology; Graft Survival; Humans; Infusions, Intra-Arterial; Leg - blood supply; Male; Middle Aged; Regional Blood Flow; Thrombosis - drug therapy; Thrombosis - etiology; Urokinase-Type Plasminogen Activator - administration & dosage; Urokinase-Type Plasminogen Activator - adverse effects; Urokinase-Type Plasminogen Activator - therapeutic use; Vascular Patency
• ISSN: 0033-8419
• DOI: 10.1148/radiology.172.1.2740523

The initial outcome, long-term patency rate, and rate of limb salvage were studied in patients after regional urokinase infusion for treatment of thrombosed lower-extremity grafts. Seventy-one infusions were performed in 53 patients. Complete clot lysis occurred in 75% of grafts, with establishment of antegrade blood flow in 66%. Variables that favorably influenced clot lysis and the reestablishment of antegrade blood flow through the graft were a short duration of occlusion and a suprainguinal graft position. The median duration of patency after infusion and adjunctive therapy was 162 days, with 75% limb salvage at 301 days. No statistically significant variables that influenced the length of patency were identified. These long-term patency results are inferior to the reported results in suprainguinal grafts after reoperation. They appear similar to reported results for occluded infrainguinal grafts treated with thrombectomy and patch grafting.