keyword
https://read.qxmd.com/read/36913384/safe-and-effective-thrombolysis-in-free-flap-salvage-intra-arterial-urokinase-infusion
#1
JOURNAL ARTICLE
Jun Hyeok Kim, Sungyeon Yoon, Heeyeon Kwon, Deuk Young Oh, Young-Joon Jun, Suk-Ho Moon
Despite the high success rate in reconstruction using free tissue transfer, flap failure is often caused by microvascular thrombosis. In a small percentage of cases with complete flap loss, a salvage procedure is performed. In the present study, the effectiveness of intra-arterial urokinase infusion through the free flap tissue was investigated to develop a protocol to prevent thrombotic failure. The retrospective study evaluated the medical records of patients who underwent salvage procedure with intra-arterial urokinase infusion after reconstruction with free flap transfer between January 2013 and July 2019...
2023: PloS One
https://read.qxmd.com/read/36172738/feasibility-of-microbubble-accelerated-low-dose-thrombolysis-of-peripheral-arterial-occlusions-using-an-ultrasound-catheter
#2
JOURNAL ARTICLE
Sabrina A N Doelare, Johanna H Nederhoed, Josje M Evers, Sebastiaan T Roos, Otto Kamp, René J P Musters, Willem Wisselink, Vincent Jongkind, Harm P Ebben, Kak K Yeung
PURPOSE: Intra-arterial administration of microbubbles (MBs) through an ultrasound (US) catheter increases the local concentration of MBs into the thrombus and may further enhance outcomes of contrast-enhanced sonothrombolysis (CEST). The objective of this study was to evaluate the feasibility and lytic efficacy of intra-arterial infusion of MBs during US-enhanced thrombolysis in both in vitro and in vivo peripheral arterial occluded models. MATERIALS AND METHODS: SonoVue and Luminity MBs were infused at a flow rate of 20 mL/h through either the drug delivery lumen of the US catheter (DDC, n=20) or through the tube lumen of the vascular phantom (systematic infusion, n=20) during thrombolysis with a low-dose urokinase (UK) protocol (50 000 IU/h) with(out) US application to assess MB survivability and size by pre-treatment and post-treatment measurements...
September 29, 2022: Journal of Endovascular Therapy
https://read.qxmd.com/read/35945566/dual-thrombolytic-therapy-with-mutant-pro-urokinase-and-small-bolus-alteplase-for-ischemic-stroke-dumas-study-protocol-for-a-multicenter-randomized-controlled-phase-ii-trial
#3
JOURNAL ARTICLE
Nadinda A M van der Ende, Bob Roozenbeek, Lucas E M Smagge, Sven P R Luijten, Leo A M Aerden, Petra Kraayeveld, Ido R van den Wijngaard, Geert J Lycklama À Nijeholt, Heleen M den Hertog, H Zwenneke Flach, Alexis C Wallace, Victor Gurewich, Gregory J Del Zoppo, William J Meurer, Hester F Lingsma, Aad van der Lugt, Diederik W J Dippel
BACKGROUND: The effectiveness of alteplase for ischemic stroke treatment is limited, partly due to the occurrence of intracranial and extracranial hemorrhage. Mutant pro-urokinase (m-proUK) does not deplete fibrinogen and lyses fibrin only after induction with alteplase. Therefore, this treatment has the potential to be safer and more efficacious than treatment with alteplase alone. The aim of this study is to assess the safety and efficacy of thrombolytic treatment consisting of a small bolus alteplase followed by m-proUK compared with standard thrombolytic treatment with alteplase in patients presenting with ischemic stroke...
August 9, 2022: Trials
https://read.qxmd.com/read/33832122/treatment-challenges-in-patients-with-early-acute-massive-pulmonary-thrombosis-embolism-pte-after-lung-cancer-surgery-a-case-report
#4
JOURNAL ARTICLE
Jian Shen, Mi Zhou, Weihua Shao, Haiyun Dai
INTRODUCTION: Early acute massive pulmonary thrombosis embolism (PTE) after lung cancer surgery is one of the most fatal surgical complications. It is often accompanied by shock and hypotension, with high mortality rate. Due to surgical wounds, patients with early acute massive PTE after lung cancer surgery have a high risk of thrombolytic bleeding, which renders treatment more challenging and there is currently no standard protocol on how to safely and effectively treat these patients in the clinic...
April 9, 2021: Medicine (Baltimore)
https://read.qxmd.com/read/31466489/prospective-audit-to-study-urokinase-use-to-restore-patency-in-occluded-central-venous-catheters-passport-1
#5
MULTICENTER STUDY
Mick John Kumwenda, Sandip Mitra, Aurangzaib Khawaja, Nicholas Inston, Peter Nightingale
OBJECTIVES: Tunnelled central venous catheters dysfunction can be defined as failure to provide blood flow above 200 mL/min during dialysis often caused by thrombosis. Although urokinase is used routinely for thrombolysis, there is wide variation in dose regimens. A multidisciplinary group was formed to address this issue and offer guidance. METHODS: Dialysis centres that used urokinase in the United Kingdom took part in a prospective study to determine the safety and outcomes of thrombolysis using agreed protocols...
November 2019: Journal of Vascular Access
https://read.qxmd.com/read/30086999/catheter-related-infections-in-patients-with-acute-type-ii-intestinal-failure-admitted-to-a-national-centre-incidence-and-outcomes
#6
JOURNAL ARTICLE
A Bond, A Teubner, M Taylor, C Cawley, J Varden, A Abraham, P R Chadwick, M Soop, G L Carlson, S Lal
INTRODUCTION: The management of intestinal failure (IF) requires safe and sustained delivery of parenteral nutrition (PN). The long-term maintenance of central venous catheter (CVC) access is therefore vital, with meticulous catheter care and salvage of infected CVCs being of prime importance. CVC-related infection and loss of intravenous access are important causes of morbidity and mortality in IF. Avoidance, prompt recognition and appropriate management of CVC-related infections are crucial components of IF care...
August 2019: Clinical Nutrition
https://read.qxmd.com/read/28801387/microbubbles-and-ultrasound-accelerated-thrombolysis-must-for-peripheral-arterial-occlusions-protocol-for-a-phase-ii-single-arm-trial
#7
JOURNAL ARTICLE
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://read.qxmd.com/read/26217634/thrombolytic-therapy-using-urokinase-for-management-of-central-venous-catheter-thrombosis
#8
JOURNAL ARTICLE
Jung Tack Son, Sun Young Min, Jae Il Kim, Pyong Wha Choi, Tae Gil Heo, Myung Soo Lee, Chul-Nam Kim, Hong-Yong Kim, Seong Yoon Yi, Hye Ran Lee, Young-Nam Roh
PURPOSE: The management of central venous catheters (CVCs) and catheter thrombosis vary among centers, and the efficacy of the methods of management of catheter thrombosis in CVCs is rarely reported. We investigated the efficacy of bedside thrombolysis with urokinase for the management of catheter thrombosis. MATERIALS AND METHODS: We retrospectively reviewed data from patients who had undergone CVC insertion by a single surgeon in a single center between April 2012 and June 2014...
December 2014: Vascular Specialist International
https://read.qxmd.com/read/24768365/therapeutic-application-of-contrast-enhanced-ultrasound-and-low-dose-urokinase-for-thrombolysis-in-a-porcine-model-of-acute-peripheral-arterial-occlusion
#9
JOURNAL ARTICLE
Harm P Ebben, Johanna H Nederhoed, Jeroen Slikkerveer, Otto Kamp, Geert W J M Tangelder, René J P Musters, Willem Wisselink, Kak K Yeung
BACKGROUND: The addition of local ultrasound (US) with a contrast agent to standard intra-arterial thrombolysis can accelerate the thrombolytic treatment of stroke and myocardial infarction. The contrast agent consists of microsized gas-filled bubbles that collapse when exposed to US, causing destabilization of the clot and making the clot surface more susceptible to fibrinolytics. In this study, we investigated the effect of additional US and microbubbles on standard low-dose intra-arterial thrombolysis in a porcine model of extensive peripheral arterial occlusion...
August 2015: Journal of Vascular Surgery
https://read.qxmd.com/read/23555532/deep-vein-thrombosis-in-orthopedic-surgery-of-the-lower-extremities
#10
JOURNAL ARTICLE
Masatoshi Motohashi, Akira Adachi, Ko Takigami, Keishu Yasuda, Masayuki Inoue, Shigeyuki Sasaki, Yoshiro Matsui
To prevent pulmonary embolism due to deep venous thrombosis (DVT), we have treated 611 patients undergoing orthopedic surgery of the lower extremities with our protocol including pre- and postoperative ultrasonic venous screening and anticoagulant therapy if necessary. A total of 118 patients (19.3%) developed DVT. Among demographic and clinical factors, the site of operation (knee joint surgery: odds ratio 5.17), age (>60: odds ratio 3.91), and operation time (>120 minutes: odds ratio 4.52) were identified as significant risk factors of development of DVT...
2012: Annals of Vascular Diseases
https://read.qxmd.com/read/20875382/high-dose-urokinase-for-restoration-of-patency-of-occluded-permanent-central-venous-catheters-in-hemodialysis-patients
#11
JOURNAL ARTICLE
L Shavit, M Lifschitz, J Plaksin, T Grenader, I Slotki
BACKGROUND: Catheter thrombosis is common and results in inadequate dialysis treatment and, frequently, in catheter loss. Since dialysis treatment runs on a strict schedule, occluded catheters need to be restored in a timely and cost effective manner. We present a new shortened protocol of urokinase infusion that allows hemodialysis to be performed within 90 minutes. METHODS: To chronic hemodialysis patients, who developed complete catheter occlusion, urokinase was infused simultaneously through both lumens of the catheter (125,000 units to each lumen) over 90 minutes...
October 2010: Clinical Nephrology
https://read.qxmd.com/read/20667190/evaluation-of-local-intra-arterial-fibrinolytic-therapy-for-acute-middle-cerebral-artery-occlusion
#12
JOURNAL ARTICLE
S Tamatani, O Sasaki, T Koizumi, K Nishimaki, Y Ito, T Koike, S Takeuchi, R Tanaka
Fibrinolytic therapy for acute ischaemic stroke has been investigated in several clinical trials, with various protocols. This retrospective study was undertaken to evaluate the efficacy and limitation of local intra-arterial fibrinolytic therapy using urokinase (UK) in patients with acute middle cerebral artery occlusion. Fifty patients were treated with local intra-arterial fibrinolytic therapy within six hours after onset of symptoms. The median National Institutes of Health Stroke Scale (NIHSS) score was 17 (range, 6 to 28)...
June 30, 2000: Interventional Neuroradiology
https://read.qxmd.com/read/19776049/intraperitoneal-urokinase-and-oral-rifampicin-for-persisting-asymptomatic-dialysate-infection-following-acute-coagulase-negative-staphylococcus-peritonitis
#13
JOURNAL ARTICLE
Nathalie Demoulin, Eric Goffin
BACKGROUND: Coagulase-negative staphylococcus (CoNS) is responsible for cases of refractory and relapsing peritonitis in peritoneal dialysis (PD) patients, probably by biofilm formation on the catheter. The ISPD recommends catheter removal in such cases. Urokinase has been used to dissolve the biofilm lining the PD catheter, thus favoring antibiotic efficacy. Rifampicin has shown its efficacy in penetrating CoNS biofilm. METHODS: We defined persisting asymptomatic CoNS dialysate infection as a peritonitis episode with clinical improvement within 48 hours and dialysate clearing, but with persisting positive dialysate cultures...
September 2009: Peritoneal Dialysis International
https://read.qxmd.com/read/19394731/sodium-citrate-versus-heparin-catheter-locks-for-cuffed-central-venous-catheters-a-single-center-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Albert Power, Neill Duncan, Seema K Singh, Wendy Brown, Elizabeth Dalby, Claire Edwards, Kathleen Lynch, Virginia Prout, Tom Cairns, Megan Griffith, Adam McLean, Andrew Palmer, David Taube
BACKGROUND: Sodium citrate has antibacterial and anticoagulant properties that are confined to the catheter when used as a catheter lock. Studies of its use as a catheter lock have suggested its efficacy in preventing infection and bleeding complications compared with sodium heparin. STUDY DESIGN: Open-label randomized controlled trial of 2 catheter locks to examine the hypothesis that sodium citrate catheter locks will reduce catheter-related bacteremia and exit-site infection...
June 2009: American Journal of Kidney Diseases
https://read.qxmd.com/read/18518727/the-effect-of-lumboventricular-lavage-and-simultaneous-low-frequency-head-motion-therapy-after-severe-subarachnoid-hemorrhage-results-of-a-single-center-prospective-phase-ii-trial
#15
JOURNAL ARTICLE
Daniel Hänggi, Julia Liersch, Bernd Turowski, Mei Yong, Hans-Jakob Steiger
OBJECT: The authors of recent publications have suggested that a combination of cisternal irrigation and head-shaking therapy might reduce cerebral vasospasm after subarachnoid hemorrhage (SAH) and therefore improve outcome. The authors undertook this prospective nonrandomized Phase II study to analyze the effect of enhanced washout by lumboventricular irrigation in combination with head motion (lateral rotational therapy) on the clot clearance (CC) rate, development of cerebral vasospasm, and clinical outcome...
June 2008: Journal of Neurosurgery
https://read.qxmd.com/read/18365776/-outcome-of-intraarterial-procedures-in-acute-ischemic-stroke
#16
JOURNAL ARTICLE
E Martínez-Fernández, A González, A Gil-Peralta, J R González-Marcos, A Mayol Deyá
INTRODUCTION: In addition to the thrombolytic agents, mechanical devices are being used in intraarterial procedures in acute stroke patients. The intervention protocol and outcomes of intraarterial procedures performed in the Hospital Virgen del Rocío in 2003-2004 are described. METHODS: The results in each arterial occlusion site and case-control study of the middle cerebral artery (MCA), the placebo group in PROACT II study (Prolyse in Acute Cerebral Thromboembolism II) as historic control group, are described...
January 2008: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://read.qxmd.com/read/17881929/reteplase-provocative-visceral-arteriography
#17
JOURNAL ARTICLE
David M Widlus, Ari I Salis
GOALS: To present the results of a new protocol for provocative visceral arteriography. BACKGROUND: Acute lower gastrointestinal hemorrhage (LGIB) usually stops spontaneously. In the absence of an identifiable source, if bleeding is recurrent, provocative visceral arteriography has been advocated for diagnosis. Prior studies using Streptokinase, Urokinase, or tissue plasminogen activator have reported a 33% to 37.5% rate of identifying the site of hemorrhage. STUDY: We report a retrospective analysis of 9 patients in whom provocative visceral arteriography was performed using a new protocol with Reteplase as the fibrinolytic agent...
October 2007: Journal of Clinical Gastroenterology
https://read.qxmd.com/read/16626848/-salvage-of-digits-replantations-by-direct-arterial-antithrombotic-infusion
#18
JOURNAL ARTICLE
A Oufquir, J Bakhach, B Panconi, J-C Guimberteau, J Baudet
At the end of the seventy, we saw the reconstructive microsurgery developed to such an extent that it became a new and an independent surgical specialty. The development of the microsurgical instrumentation and the description of the surgical anatomy allowed the application of this technology to the most complex plastic reconstructions and particularly to the replantation of the amputated digits, especially the very distal digital amputations. Nowadays, the indications of digital replantation are well-defined according to numerous parameters conditioning the anatomical result and the functional outcome...
December 2006: Annales de Chirurgie Plastique et Esthétique
https://read.qxmd.com/read/16180551/analysis-of-rt-pa-infusion-in-tunnelled-dialysis-catheters
#19
JOURNAL ARTICLE
J Davies, J Casey, C Li, A V Crowe, P McClelland
Urokinase and streptokinase are commonly used thrombolytic agents for obstructed central venous catheters. Although proven to be efficacious, these agents have the potential to induce fibrin breakdown and streptokinase cannot be used repeatedly due to its allergenic nature. Documented evidence suggests that urokinase is safe and effective (> 70% efficacy for catheter installation) however further evidence points to tissue-type plasminogen activator (rt-PA) achieving as much as 98% success. This study reports on the safety and efficacy of alternative catheter thrombolysis, namely rt-PA and evaluates the efficacy of rt-PA...
April 2005: EDTNA/ERCA Journal
https://read.qxmd.com/read/15983773/rescue-localized-intra-arterial-thrombolysis-for-hyperacute-mca-ischemic-stroke-patients-after-early-non-responsive-intravenous-tissue-plasminogen-activator-therapy
#20
JOURNAL ARTICLE
Dong Joon Kim, Dong Ik Kim, Seo Hyun Kim, Kyung Yeol Lee, Ji Hoe Heo, Sang Won Han
The outcome of patients who show no early response to intravenous (i.v.) tissue plasminogen activator (tPA) therapy is poor. The objective of this study was to evaluate the feasibility of rescue localized intra-arterial thrombolysis (LIT) therapy for acute ischemic stroke patients after an early non-responsive i.v. tPA therapy. Patients with proximal MCA occlusions who were treated by LIT (n = 10) after failure of early response [no improvement or improvement of National Institute of Health Stroke Scale (NIHSS) scores of < or = 3] to i...
August 2005: Neuroradiology
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