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Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms.

Publication ,  Journal Article
Greenberg, RK; Ouriel, K; Srivastava, S; Shortell, C; Ivancev, K; Waldman, D; Illig, K; Green, R
Published in: J Vasc Interv Radiol
February 2000

PURPOSE: To assess differing mechanisms of thrombolysis determining time to reperfusion, completeness of thrombus dissolution, and embolic potential. MATERIALS AND METHODS: An in vitro perfusion model designed to mimic arterial flow conditions was created. Bifurcated limbs allowed continuous flow through one channel and the placement of radiolabeled (iodine-125) thrombus housed in a 5-cm segment of polytetrafluoroethylene graft in the other. The three experimental groups consisted of a standard continuous urokinase infusion, a pulsed pressurized injection of saline, and a similar injection with urokinase. A continuous infusion of 5% dextrose served as a control group. Time to reflow (as assessed with ultrasonic flow monitoring), completeness of thrombus dissolution (I-125 liberated into solution), and the number and size of embolic particles produced (detected by a series of graduated filter sizes) were analyzed. RESULTS: Time to reflow was significantly faster for both groups when pressurized injections were used (P < .001). There was no reflow in the control arm at 90 minutes. Completeness of thrombus dissolution was higher when a continuous infusion of urokinase was used in comparison to either of the power injection groups or the control (P < .05). The amount of embolic debris produced was significantly lower with a continuous infusion of urokinase compared with either of the power lysis groups (P < .05), but significantly greater than the control arm (P < .001). The size of the embolic particles in the power pulsed lysis groups was significantly decreased by the addition of urokinase (P < .05). CONCLUSIONS: Reflow is more rapidly established by the use of mechanical means. However, a less complete dissolution of thrombus in conjunction with a greater amount of embolic debris is achieved with this approach. The size of the embolic particles produced is reduced by the addition of a thrombolytic agent.

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Published In

J Vasc Interv Radiol

DOI

ISSN

1051-0443

Publication Date

February 2000

Volume

11

Issue

2 Pt 1

Start / End Page

199 / 205

Location

United States

Related Subject Headings

  • Urokinase-Type Plasminogen Activator
  • Thrombosis
  • Thrombolytic Therapy
  • Thrombectomy
  • Polytetrafluoroethylene
  • Plasminogen Activators
  • Nuclear Medicine & Medical Imaging
  • Models, Cardiovascular
  • Humans
  • Graft Occlusion, Vascular
 

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Greenberg, R. K., Ouriel, K., Srivastava, S., Shortell, C., Ivancev, K., Waldman, D., … Green, R. (2000). Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms. J Vasc Interv Radiol, 11(2 Pt 1), 199–205. https://doi.org/10.1016/s1051-0443(07)61465-1
Greenberg, R. K., K. Ouriel, S. Srivastava, C. Shortell, K. Ivancev, D. Waldman, K. Illig, and R. Green. “Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms.J Vasc Interv Radiol 11, no. 2 Pt 1 (February 2000): 199–205. https://doi.org/10.1016/s1051-0443(07)61465-1.
Greenberg RK, Ouriel K, Srivastava S, Shortell C, Ivancev K, Waldman D, et al. Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms. J Vasc Interv Radiol. 2000 Feb;11(2 Pt 1):199–205.
Greenberg, R. K., et al. “Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms.J Vasc Interv Radiol, vol. 11, no. 2 Pt 1, Feb. 2000, pp. 199–205. Pubmed, doi:10.1016/s1051-0443(07)61465-1.
Greenberg RK, Ouriel K, Srivastava S, Shortell C, Ivancev K, Waldman D, Illig K, Green R. Mechanical versus chemical thrombolysis: an in vitro differentiation of thrombolytic mechanisms. J Vasc Interv Radiol. 2000 Feb;11(2 Pt 1):199–205.
Journal cover image

Published In

J Vasc Interv Radiol

DOI

ISSN

1051-0443

Publication Date

February 2000

Volume

11

Issue

2 Pt 1

Start / End Page

199 / 205

Location

United States

Related Subject Headings

  • Urokinase-Type Plasminogen Activator
  • Thrombosis
  • Thrombolytic Therapy
  • Thrombectomy
  • Polytetrafluoroethylene
  • Plasminogen Activators
  • Nuclear Medicine & Medical Imaging
  • Models, Cardiovascular
  • Humans
  • Graft Occlusion, Vascular