Wd. Haire et al., UROKINASE VERSUS RECOMBINANT TISSUE-PLASMINOGEN ACTIVATOR IN THROMBOSED CENTRAL VENOUS CATHETERS - A DOUBLE-BLINDED, RANDOMIZED TRIAL, Thrombosis and haemostasis, 72(4), 1994, pp. 543-547
Fifty dysfunctional central venous catheters proven radiographically t
o be occluded by thrombus were blindly randomized to be injected with
either 2 mg recombinant tissue plasminogen activator (t-PA) or 10,000
units of urokinase (UK) and allowed to incubate for 2 h. A second dose
was allowed if catheter function was not restored with the first inje
ction. Repeat radiograph contrast injection was done when catheter fun
ction was restored or after 2 doses of study drug were administered, w
hichever occurred first. Thirteen of 22 catheters randomized to UK had
full function restored compared to 25 of 28 randomized to t-PA (p = 0
.013). Radiographic contrast injection showed 7 catheters randomized t
o UK had complete resolution of the thrombus compared to 17 randomized
to t-PA (p = 0.042). Four catheters randomized to UK had complete res
olution of the thrombus after a single dose compared to 13 randomized
to t-PA (p = 0.036). A novel dose of 2 mg of t-PA restored catheter fu
nction more reliably and dissolved thrombi faster than twice the stand
ard, FDA-approved dose of UK.