Catheter-based local thrombolysis with urokinase: Comparative efficacy of intraluminal clot lysis with conventional urokinase infusion techniques in an in vivo porcine thrombus model

Mitchel, Joseph F.; Shwedick, Michael; Alberghini, Tod V.; Knibbs, David R.; McKay, Raymond G.

doi:10.1002/(sici)1097-0304(199707)41:3<293::aid-ccd10>3.0.co;2-p

Cited by 15 publications

(7 citation statements)

References 21 publications

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“…The retention time of the delivered drug within the artery wall is also highly variable and is largely dependent on the properties of the delivered compound. Typically, compounds are retained for anything up to 24 h, although times of up to 21 days have been reported (7,34,36,38,(40)(41)(42)(77)(78)(79).…”

Section: Targeting Restenosis By Local Drug Delivery (Ldd)mentioning

confidence: 99%

Transforming Growth Factor‐β:A Promising Target for Anti‐Stenosis Therapy

Chamberlain

2001

Cardiovascular Drug Reviews

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Transforming growth factor-â (TGF-â) is the general name for a family of cytokines which have widespread effects on many aspects of growth and development. The TGF-â isoforms are produced by most cell types and exert a wide range of effects in a context-dependent autocrine, paracrine or endocrine fashion via interactions with distinct receptors on the cell surface. TGF-â is involved in the wound healing process and, thus plays a significant role in the formation of a restenotic lesion after percutaneous transluminal coronary angioplasty (PTCA) or stenting. Perhaps because of its wide-ranging effects, TGF-â is usually released from cells in a latent form, and its activation and signaling are complex. Manipulation of the TGF-â1, TGF-â2, and TGF-â3 isoforms by inhibiting their expression, activation, or signaling reduces scarring and fibrosis in animal models. However, to date, few have reached clinical trial. This review summarizes current knowledge on the activation and signaling of TGF-â, and focuses on the anti-TGF-â strategies which may lead to clinical applications in the prevention of restenosis following PTCA or stenting.

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Section: Targeting Restenosis By Local Drug Delivery (Ldd)mentioning

confidence: 99%

Transforming Growth Factor‐β:A Promising Target for Anti‐Stenosis Therapy

Chamberlain

2001

Cardiovascular Drug Reviews

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“…Hydrogelcoated coronary angioplasty balloon catheters have been used in the past for local delivery of anticoagulant agents including heparin as well as thrombolytics, leading to successful inhibition of platelet-dependent thrombosis [7,8]. A relatively smaller dose of thrombolytics was required to produce results comparable to prolonged infusion using this technique, which was also shown to reduce hemorrhagic complications [9]. Delivery of thrombolytics into the thrombus under low pressure using the Clearway balloon catheter, may allow for deeper penetration of the drug into the thrombus, and could also preclude or reduce the duration of prolonged infusion of thrombolytics, probably reducing hemorrhagic complications.…”

Section: Discussionmentioning

confidence: 99%

Use of simultaneous angioplasty and in situ thrombolysis with a specialized balloon catheter for peripheral interventions

Rathi

Latif

Exaire

et al. 2008

J Thromb Thrombolysis

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The treatment of acute limb ischemia is always challenging. Various techniques including balloon angioplasty, rheolytic thrombectomy, and prolonged localized infusion of thrombolytics are often used to achieve revascularization. However, some patients with suboptimal angiographic results may benefit from novel alternatives such as the Clearway irrigation balloon (Atrium, Hudson, NH, USA). This device allows simultaneous low-pressure balloon angioplasty and delivery of thrombolytics in situ in patients with arterial or venous thrombosis. This strategy may improve the acute angiographic results in complex acute limb ischemia cases.

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“…However, prior experiences in animal studies and the coronary field allow us to extrapolate such results (9, 10). MITCHELL et al showed that the quantity of artificial clot lysis and the rate of recanalization was significantly enhanced by using special local-delivery catheters capable of mechanical disruption of the clot simultaneously with delivery of high concentrations of urokinase directly on the surface of the thrombus (10). A review of multiple randomized trials of primary angioplasty versus i.v.…”

Section: Discussionmentioning

confidence: 99%