MONOCLONAL-ANTIBODY C7E3 FAB AS AN ADJUNC T FOR THROMBOLYSIS OF PERIPHERAL ARTERIES

Thrombolysis of arterial occlusions has limitations, e.g. it requires extensive time for thrombolysis, occlusions may be resistant to lysis, and the rate of reocclusions may be high. c7E3 Fab inhibits platelet aggregation by binding to the GPIIb/IIIa receptor on platelets. Experi mentally, this monoclonal antibody has been shown to decrease, the tim e required for lysis, and to prevent reocclusion. This is the first re port on the adjunctive use of c7E3 Fab in peripheral arteria[ occlusio ns in humans. Three patients with occlusion of the iliac or femoropopl iteal artery were treated with c7E3 Fab (bolus injection of 0.25 mg/kg KC + i.v.-application 12 mu g/min for 12h). In addition, the patients received urokinase (100,000IU bolus + 700,000IU/h), heparin (5,000IU bolus + 1,000IU/h) and acetylsalicylate (100mg/day/p.o.). Occlusion le ngth ranged between 6-40 cm. Therapy was successful in all patients. D uring the follow-up period (4-6 months) no reocclusion occurred. There were no serious side effects like major bleeding or thrombocytopenia. We conclude that the applied doses appear safe. Even the time require d for thrombolysis was short, a conclusion in respect of a significant reduction of the time required for lysis can be drawn only after furt her controlled studies.