Thrombolytic drugs may be an alternative therapy for acute limb ischemia in patients who are not surgically treatable.
Two cases of acute limb ischemia managed successfully with a sequential intraarterial infusion of urokinase and recombinant-type tissue plasminogen activator (rt-TPA) are reported.
The positive results suggest the two drugs have a synergistic action. Further studies are needed to demonstrate the interactions between these thrombolytic agents
Get full access to this article
View all access options for this article.
References
1.
Dryjski M., Swedenborg J.: Acute thrombosis and embolism of the extremities: Factors influencing the result of treatment. Acta Chir Scand148:135-139, 1982
2.
Elliott JP, Hageman Jh, Szilagyi DE, et al: Arterial embolization: Problems of source, multiplicity, recurrence and delayed treatment. Surgery88:833-845, 1980.
3.
Collen D., Van De Werf F.: Coronary arterial thrombolysis with low-dose synergistic combinations of recombinant tissue-type plasminogen activator (rt-PA) and recombinant single-chain urokinase-type plasminogen activator (rscu-PA) for acute myocardial infarction . Am J Cardiol60:431-434, 1987.
4.
Collen D., De Cock F., Demarsin E., et al: Absence of Synergysm between tissue-type plasminogen activator (t-PA), single chain urokinase-type plasminogen activator (scu-PA) and urokinase on clot lysis in a plasma milieu in vitro. Thromb Haemost56:35-39, 1986.
5.
Spriggs DJ, Stassen JM, Hashimoto Y., et al: Thrombolytic properties of human tissue-type plasminogen activator, single-chain urokinase-type plasminogen activator, and synergystic combinations in venous thrombosis models in dogs and rabbits. Blood73:1207-1212, 1989.
6.
Topol EJ, Califf RM, George BS, et al: Coronary arterial thrombolysis with combined infusion of recombinant tissue-type plasminogen activator and urokinase in patients with acute myocardial infarction. Circulation77:1100-1107, 1988 .