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Urokinase infusion

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https://www.readbyqxmd.com/read/29155385/local-low-dose-urokinase-thrombolysis-for-the-management-of-hemodynamically-stable-pulmonary-embolism-with-right-ventricular-dysfunction
#1
Sara Alcántara Carmona, Marina Pérez Redondo, Luis Nombela Franco, Rocío González Costero, Bárbara Balandín Moreno, Miguel Valdivia de la Fuente, Santiago Méndez Alonso, Agustín García Suárez, Ana Royuela
AIMS: To evaluate the effectiveness of local low-dose urokinase thrombolysis (LLDUT) in hemodynamically stable pulmonary embolism with right ventricular dysfunction (RVD). METHODS AND RESULTS: Prospective study. LLDUT with a 200,000 IU bolus followed by a 100,000 IU/h infusion. Treatment duration was determined through radiological control performed 48-72h into treatment. Follow-up echocardiogram was performed within seven days after LLDUT completion. Evolution of thrombus burden, pulmonary artery pressures (PAP) and RVD were studied, and hemorrhagic complications and mortality were recorded...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29154937/effect-of-human-recombinant-prourokinase-rhpro-uk-on-thromboembolic-stroke-in-rats
#2
Chun-Hua Hao, Wen-Xia Ding, Qian Sun, Xin-Xin Li, Wei-Ting Wang, Zhuan-You Zhao, Li-da Tang
We evaluated the efficacy and safety of human recombinant prourokinase ( rhpro-UK) on thromboembolic stroke in rats. 60 rats with thromboembolic stroke were divided into 6 groups (n = 10). The model group was given saline, the reagent groups were given rhpro-UK (5, 10, 20 × 104U/kg), and positive control groups were given urokinase (UK) 10 × 104U/kg and recombinant tissue plasminogen activator (rt-PA) 9mg/kg through intravenous infusion at 1.5h after embolism. And other 10 rats without occluded by autologous blood clots as the sham group were given saline...
November 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29151701/clinical-outcomes-of-transcatheter-selective-superior-mesenteric-artery-urokinase-infusion-therapy-vs-transjugular-intrahepatic-portosystemic-shunt-in-patients-with-cirrhosis-and-acute-portal-vein-thrombosis
#3
Ting-Ting Jiang, Xiao-Ping Luo, Jian-Ming Sun, Jian Gao
AIM: To compare the outcomes of transcatheter superior mesenteric artery (SMA) urokinase infusion and transjugular intrahepatic portosystemic shunt (TIPS) for acute portal vein thrombosis (PVT) in cirrhosis. METHODS: From January 2013 to December 2014, patients with liver cirrhosis and acute symptomatic PVT who met the inclusion criteria were randomly assigned to either an SMA group or a TIPS group. The two groups accepted transcatheter selective SMA urokinase infusion therapy and TIPS, respectively...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29069046/analysis-of-three-surgical-treatments-for-spontaneous-supratentorial-intracerebral-hemorrhage
#4
Qiang Cai, Huaping Zhang, Dong Zhao, Zhaohui Yang, Keqi Hu, Long Wang, Wenfei Zhang, Zhibiao Chen, Qianxue Chen
This retrospective study aimed to evaluate the effectiveness and safety of 3 surgical procedures for Spontaneous Supratentorial Intracerebral Hemorrhage (SICH).A total of 63 patients with SICH were randomized into 3 groups. Group A (n = 21) underwent craniotomy surgery, group B (n = 22) underwent burr hole, urokinase infusion and catheter drainage, and group C (n = 20) underwent neuroendoscopic surgery. The hematoma evacuation rate of the operation was analyzed by 3D Slice software and the average surgery time, visualization during operation, decompressive effect, mortality, Glasgow Coma Scale (GCS) improvement, complications include rebleeding, pneumonia, intracranial infection were also compared among 3 groups...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28838459/thromboembolism-induced-by-umbilical-cord-mesenchymal-stem-cell-infusion-a-report-of-two-cases-and-literature-review
#5
Z Wu, S Zhang, L Zhou, J Cai, J Tan, X Gao, Z Zeng, D Li
OBJECTIVE: To investigate the thromboembolism induced by blood-mediated inflammatory reactions against infused cells during the clinical application of stem cells. METHODS: Two patients with renal transplantation and chronic kidney disease, respectively, experienced thromboembolism after umbilical cord mesenchymal stem cell (UCMSC) infusion. The clinical manifestations and the laboratory test results were collected and analyzed. RESULTS: The patients received stem cell infusion through the peripheral veins and presented with a swollen and painful forearm postinfusion...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28801387/microbubbles-and-ultrasound-accelerated-thrombolysis-must-for-peripheral-arterial-occlusions-protocol-for-a-phase-ii-single-arm-trial
#6
Harm P Ebben, Johanna H Nederhoed, Rutger J Lely, Willem Wisselink, Kakkhee Yeung
INTRODUCTION: Acute peripheral arterial occlusions can be treated with intra-arterial catheter-directed thrombolysis as an alternative to surgical thromboembolectomy. Although less invasive, this treatment is time-consuming and carries a significant risk of haemorrhagic complications. Contrast-enhanced ultrasound using microbubbles could accelerate dissolution of thrombi by thrombolytic medications due to mechanical effects caused by oscillation; this could allow for lower dosages of thrombolytics and faster thrombolysis, thereby reducing the risk of haemorrhagic complications...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28395416/-application-of-percutaneous-angiojet-thrombectomy-in-patients-with-acute-symptomatic-portal-and-superior-mesenteric-venous-thrombosis
#7
J H Song, X He, W S Lou, L Chen, G P Chen, H B Su, W Y Shi, T Wang, B X Zhao, J P Gu
Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV)...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28352362/feasibility-of-continuous-catheter-directed-thrombolysis-using-low-dose-urokinase-in-combination-with-low-molecular-weight-heparin-for-acute-iliofemoral-venous-thrombosis-in-patients-at-risk-of-bleeding
#8
Guoping Chen, Wangyin Shi, Xu He, Wensheng Lou, Liang Chen, Jianping Gu
The present study aimed to examine the feasibility of catheter-directed thrombolysis (CDT) using continuous infusion of low-dose urokinase in combination with low molecular weight heparin (LMWH) for acute iliofemoral venous thrombosis. This retrospective analysis included patients with symptomatic acute iliofemoral venous thrombosis who received CDT using continuous infusion of low-dose urokinase in combination with LMWH within the past four years. Urokinase was administered at 1×10(4) U/h and 2×10(4) U/h in patients at high-risk and low-risk of bleeding, respectively...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28336948/plasminogen-activator-inhibitor-1-protects-mice-against-cardiac-fibrosis-by-inhibiting-urokinase-type-plasminogen-activator-mediated-plasminogen-activation
#9
Kamlesh K Gupta, Deborah L Donahue, Mayra J Sandoval-Cooper, Francis J Castellino, Victoria A Ploplis
Plasminogen activator inhibitor-1 (PAI-1) is known to protect mice against cardiac fibrosis. It has been speculated that PAI-1 may regulate cardiac fibrosis by inactivating urokinase-type plasminogen activator (uPA) and ultimately plasmin (Pm) generation. However, the in vivo role of PAI-1 in inactivating uPA and limiting the generation of Pm during cardiac fibrosis remains to be established. The objective of this study was to determine if the cardioprotective effect of PAI-1 is mediated through its ability to directly regulate urokinase -mediated activation of plasminogen (Pg)...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27810050/therapeutic-fibrinolysis-how-efficacy-and-safety-can-be-improved
#10
REVIEW
Victor Gurewich
Therapeutic fibrinolysis has been dominated by the experience with tissue-type plasminogen activator (t-PA), which proved little better than streptokinase in acute myocardial infarction. In contrast, endogenous fibrinolysis, using one-thousandth of the t-PA concentration, is regularly lysing fibrin and induced Thrombolysis In Myocardial Infarction flow grade 3 patency in 15% of patients with acute myocardial infarction. This efficacy is due to the effects of t-PA and urokinase plasminogen activator (uPA). They are complementary in fibrinolysis so that in combination, their effect is synergistic...
November 8, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27479452/neonatal-central-venous-catheter-thrombosis-diagnosis-management-and-outcome
#11
Christina K Park, Bosco A Paes, Kim Nagel, Anthony K Chan, Prashanth Murthy
Thrombotic occlusion of central venous catheters (CVCs) is a common problem in newborns. No guideline systematically addresses the diagnosis, management, and prevention of this complication. The objective of this review is to establish evidence-based guidance for the management of CVC thrombosis. A comprehensive literature search was conducted from 1948 to 2012. Twenty-six articles fulfilling four criteria - humans, neonates aged less than 28 days, CVC insertion, and English language - were included for analysis...
July 29, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/27444259/stenting-as-a-rescue-treatment-after-failure-of-mechanical-thrombectomy-for-anterior-circulation-large-artery-occlusion
#12
Jang-Hyun Baek, Byung Moon Kim, Dong Joon Kim, Ji Hoe Heo, Hyo Suk Nam, Joonsang Yoo
BACKGROUND AND PURPOSE: We hypothesized that permanent stenting may be a rescue treatment for stentriever-failed anterior circulation large artery occlusion. We compared the outcomes among patients with permanent stenting and those without stenting after stentriever failure. METHODS: We retrospectively evaluated 208 patients who underwent stentriever thrombectomy for anterior circulation large artery occlusion between September 2010 and September 2015. Modified thrombolysis in cerebral ischemia 2b-3 recanalization was achieved with stentriever alone or in combination with Penumbra device in 155 patients (74...
September 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27194049/a-new-endovascular-strategy-utilizing-a-hybrid-procedure-for-long-segmental-occlusion-by-acute-arterial-thromboembolism-in-the-lower-extremity
#13
JungWon Kwak, HwanHoon Chung, SeungHwa Lee, YunHwan Kim, SungBum Cho, TaeSuk Seo, Wonmin Jo, JaeSeung Shin
PURPOSE: To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy. MATERIALS AND METHODS: In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients...
July 2016: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27089231/catheter-directed-therapy-for-acute-renal-vein-thrombosis-in-systemic-lupus-erythematosus-a-case-report
#14
Chien-Boon Jong, Wei-Yung Lo, Mu-Yang Hsieh
We report our experience using catheter-directed thrombectomy/thrombolysis (CDT) to treat a patient with acute renal vein thrombosis (RVT) associated with systemic lupus erythematosus (SLE). A 34-year-old woman presented with persistent left flank pain, and a renal ultrasonography examination revealed an enlarged left kidney. Contrast-enhanced computed tomography confirmed the presence of acute left RVT. Because medical treatment failed to relieve her pain and the renal function was deteriorating, we attempted to salvage the occluded left renal vein using an endovascular approach...
February 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26714208/thrombolysis-a-critical-first-line-therapy-with-an-unfulfilled-potential
#15
REVIEW
Victor Gurewich
A blood clot or thrombus triggers the onset of most vascular diseases, like stroke or heart attack. Thrombolysis is the only treatment that can restore blood flow rapidly and easily. Unfortunately, the standard thrombolytic, tissue plasminogen activator (tPA), has proven inadequate and is being replaced by invasive endovascular procedures, which are time consuming and limited in their availability in relation to the scope of the problem. Historically, when tPA clinical trials began, it was not recognized sufficiently that without the other natural plasminogen activator, prourokinase (proUK), thrombolysis by tPA was seriously compromised...
June 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/26677349/original-approach-for-thrombolytic-therapy-in-patients-with-ilio-femoral-deep-vein-thrombosis-2%C3%A2-years-follow-up
#16
Leslie Fiengo, Federico Bucci, Elias Khalil, Bruno Salvati
OBJECTIVE: The aim of the study was to discuss the results of catheter-directed thrombolysis and complementary procedures to treat acute iliofemoral deep vein thrombosis (DVT) evaluating the safety and effectivness of an easy access such as the Great Saphenous Vein. METHODS AND MATERIALS: A total of 22 consecutive patients with iliofemoral thrombosis and two patients with femoro-popliteal thrombosis on recent onset diagnosed with Ultrasound Doppler and contrast venography underwent intrathrombus drip infusion of urokinase while intravenous heparin was continued using saphenical access...
2015: Thrombosis Journal
https://www.readbyqxmd.com/read/26673300/-use-of-thrombolytic-therapy-and-rheolytic-thrombectomy-in-treatment-of-pulmonary-artery-thromboembolism
#17
L S Kokov, P D Matveev, O V Nikitina, P Iu Lopotovskiĭ, D A Kosolapov, N E Kudriashova, E V Migunova, I P Mikhaĭlov, F A Sharifullin, É Aiazian
The article deals with the results of combined treatment of patients with pulmonary thromboembolism by means of systemic thrombolytic therapy, anticoagulant therapy, and rheolytic thrombectomy during the period from 2012 to 2013. Thrombolytic therapy was used in 78 of 187 patients with the confirmed diagnosis of pulmonary thromboembolism (Group 1). The diagnosis was verified and therapeutic results were controlled by means of contrast-enhanced spiral computed tomography and perfusion scintigraphy. Thrombolysis was carried out using: tissue plasminogen activator - alteplase (61 cases) with administration of the full dose during 2 hours, streptokinase (14 cases) at a dose of 1...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/26467594/treatment-of-free-flowing-tuberculous-pleurisy-with-intrapleural-urokinase
#18
RANDOMIZED CONTROLLED TRIAL
G-Q Cao, L Li, Y-B Wang, Z-Z Shi, D-Y Fan, H-Y Chen
BACKGROUND AND OBJECTIVE: Patients with loculated tuberculous pleurisy (TBP) treated with urokinase suffer less from residual pleural thickening (RPT) than those treated with simple drainage. However, the role of intrapleural urokinase in free-flowing TBP patients remains unclear. METHODS: A total of 318 patients with presumed TBP were screened. The final 171 patients who participated in the study were randomly allocated to the urokinase group (n = 86) and the control group (n = 85)...
November 2015: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/26380915/full-length-soluble-urokinase-plasminogen-activator-receptor-down-modulates-nephrin-expression-in-podocytes
#19
Massimo Alfano, Paola Cinque, Guido Giusti, Silvia Proietti, Manuela Nebuloni, Silvio Danese, Silvia D'Alessio, Marco Genua, Federica Portale, Manuela Lo Porto, Pravin C Singhal, Maria Pia Rastaldi, Moin A Saleem, Domenico Mavilio, Joanna Mikulak
Increased plasma level of soluble urokinase-type plasminogen activator receptor (suPAR) was associated recently with focal segmental glomerulosclerosis (FSGS). In addition, different clinical studies observed increased concentration of suPAR in various glomerular diseases and in other human pathologies with nephrotic syndromes such as HIV and Hantavirus infection, diabetes and cardiovascular disorders. Here, we show that suPAR induces nephrin down-modulation in human podocytes. This phenomenon is mediated only by full-length suPAR, is time-and dose-dependent and is associated with the suppression of Wilms' tumor 1 (WT-1) transcription factor expression...
2015: Scientific Reports
https://www.readbyqxmd.com/read/26369877/3d-fiesta-magnetic-resonance-angiography-fusion-imaging-of-distal-segment-of-occluded-middle-cerebral-artery
#20
Tomoyoshi Kuribara, Koichi Haraguchi, Kazumi Ogane, Nobuki Matsuura, Takeo Ito
Middle cerebral artery (MCA) occlusion was examined with basi-parallel anatomical scanning (BPAS) using three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA), and 3D-FIESTA and magnetic resonance angiography (MRA) fusion images were created. We expected that an incidence of hemorrhagic complications due to vessel perforations would be decreased by obtaining vascular information beyond the occlusion and thus acute endovascular revascularization could be performed using such techniques...
2015: Neurologia Medico-chirurgica
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