J Korean Radiol Soc.  1994 May;30(5):835-841.

Peripheral Arterial Thrombolysis by Modified Pulse-Spray Method

• Lee KN
• Choi SS
• Lee YI
• Park BH
• Kim JI
• Lee JM
• Nam KJ

Abstract

PURPOSE
The purposes of this study were to evaluate the efficacy of thrombolysis and to find optimal dose of urokinase and injection time by modified pulse-spray method with multiside-hole catheter in patients of arterriosclerosis obliterans of lower limbs.
MATERIALS AND METHODS
Over a 2 month period, 5 cases of peripheral arterial occlusion of lower limbs were treated with 0.7--1.3 million unit of urokinase by modified pulse spray method. With antegrade puncture at the site of superficial femoral artery, the tip of modified pig tail catheter was initially placed approximately 2cm proximal to the distal end of the clot. The procedure started with the use of initial bolus dose of UK(100,000U) of lacing, and then small pulses of highly concentrated urokinase, which are forcefully sprayed throughout the thrombus at a rate of 20,000U/min. After the initial rapid period of deposition, the concentration of UK was reduced to 4,000U/min for residual thrombus.
RESULTS
Complete clot lysis were achieved in 3 of 5 occlusions. Mean duration for completion of lysis was 140 min(40-180min) and initial recanalization of artery required 45min(20-90min). Total required dose of UK was 1,120,000U and mean dose for initial recanalization was 660,000U. No significant complications occurred except distal vasospasm in one case.
CONCLUSION
Modified pulse spray method using ultrahigh and high dose urokinase is safe, reguires less time and has cost effectiveness in the management of peripheral arterial thrombolysis. Further study is warranted.

MeSH Terms

Arteries
Catheters
Cost-Benefit Analysis
Femoral Artery
Humans
Lower Extremity
Punctures
Thrombosis
Urokinase-Type Plasminogen Activator
Urokinase-Type Plasminogen Activator