Pharmacomechanical thrombolysis of experimental pulmonary emboli. Rapid low-dose intraembolic therapy

Chest. 1994 Nov;106(5):1558-62. doi: 10.1378/chest.106.5.1558.

Abstract

We utilized low-dose intraembolic urokinase (UK) infusions in a canine model of experimental pulmonary embolism (PE) and compared the arteriographic extent of thrombolysis with three other treatment regimens. Group 1 animals (n = 16) received the intraembolic UK infused directly into the PE offering the mechanical effect of the infusion combined with pharmacologic thrombolysis. In the group 2 animals (n = 5), UK was delivered via a guide catheter placed proximal to the clot. Group 3 animals (n = 6) were treated with a direct intraembolic saline solution infusion. Group 4 (n = 7) received only intravenous heparin. The arteriographic extent of thrombolysis was graded 1+ to 3+. The extent of thrombolysis was 2.88+ in the group 1 animals and was significantly greater than in groups 2, 3, or 4 (p = 0.003, 0.0005, and 0.0001, respectively). Fibrinogen levels did not significantly decrease with intraembolic treatment (p = 0.07). Delivery of UK directly into emboli in an experimental canine PE model appears to elicit a combined mechanical and pharmacologic effect resulting in extensive thrombolysis.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Catheterization, Peripheral / instrumentation
  • Disease Models, Animal
  • Dogs
  • Drug Evaluation, Preclinical
  • Fibrinogen / analysis
  • Fibrinogen / drug effects
  • Heparin / administration & dosage
  • Infusions, Intra-Arterial / instrumentation
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / drug therapy*
  • Radiography
  • Random Allocation
  • Thrombolytic Therapy / instrumentation
  • Thrombolytic Therapy / methods*
  • Urokinase-Type Plasminogen Activator / administration & dosage*

Substances

  • Fibrinogen
  • Heparin
  • Urokinase-Type Plasminogen Activator