Lokale Katheterlyse der Femoralarterie: rt-PA versus Urokinase

Abstract

Percutaneous, catheter-mediated lysis was performed on 56 patients with acute to subacute thrombosis of the superficial femoral artery (Fontaine stage IIb to IV). One half of the patients received rt-PA, the other half urokinase. The clinical parameters of the two groups of patients were largely the same. The therapeutical results were, at about the same treatment costs, better in the rt-PA patients group, in particular with regard to the considerably shorter average treatment period, which lasted on the average for 2 hours in the rt-PA group, vs. 6 hours in the urokinase group. The recanalisation rate was also higher in the rt-PA group (86%) vs. 75% in the urokinase group.

Recombinant Tissue Plasminogen Activator versus Urokinase for Local Thrombolysis of Femoropopliteal Occlusions: A Prospective, Randomized Multicenter Trial

“…Differing dosages, delivery techniques, and study parameters make it difficult to compare outcomes of the various studies that have so far compared UK and rtPA. 8,13,17 In one trial, 17 the occlusions were predominantly in saphenous vein grafts, the rtPA dose was extremely high (up to 130 mg), and the number of randomized patients limited (16 patients per group). In another study, 8 more patients were recruited, but the comparison was not prospective.…”

“…[1][2][3][4] At present, the 3 fibrinolytic substances commonly in use are streptokinase, [5][6][7][8] urokinase (UK), [7][8][9][10][11][12][13][14] and recombinant tissue plasminogen activator (rtPA). [15][16][17][18] The optimum thrombolytic agent, dosage, and application technique have not been established by controlled comparative studies; however, there is circumstantial evidence that urokinase and rtPA have some advantages over streptokinase and, at least in retrospect, seem to be superior in efficacy and safety. [6][7][8] The aim of this study was to compare rtPA with urokinase in terms of efficacy, safety, and clinical benefit in an open, prospective, and randomized multicenter trial.…”

Predictive factors for the removal of “soft” femoropopliteal occlusions with intraarterial short-term and high-dose urokinase treatment

“…The catheter is placed into the middle part of the occlusion fbr intrathrombotic lysis [2,3,[5][6][7][8]11,16,23,29,32]. C. The catheter is placed into the proximal part of the occlusion and moved forward step by step, according to the lyric result seen in the check-up angiograms [13,14,18,19]. The type and amount of the lyric drug used varied within the trials.…”

“…Often the period of treatment was relatively long and lasted more than six hours, e.g. Dotter [18] compared urokinase with rt-PA and did not find a significant difference in terms of revascularization (rt-PA: 86%, UK: 75%). Do et al [7] were using streptokinase, Urokinase, and rt-PA, the three of which were nearly equally effective (SK: 72%, UK: 77%, rt-PA: 81%).…”

Regionale Fibrinolyse mit rt-PA beim Hypothenar-Hammer-Syndrom

“…Bei der lokalen Lyse arterieller Verschlüsse zeigt rt-PA gegenüber Streptokinase und Urokinase raschere Erfolge und eine höhere primäre Wiedereröffnungsrate [3][4][5][6]. In einer Studie mit 120 Patienten mit arteriellen Verschlüssen der Beine lag die primäre Wiedereröffnungsrate mit rt-PA bei 90% gegenüber 81,8% bei Verwendung von Urokinase.…”