Gm. Lim et Jj. Bookstein, AUGMENTED PULSE-SPRAY THROMBOLYSIS WITH TPA BY EARLY PULSED INTRATHROMBIC PLASMINOGEN ENRICHMENT, Journal of vascular and interventional radiology, 9(4), 1998, pp. 618-625
PURPOSE: This study was designed to evaluate the efficacy of plasminog
en enrichment of subacute thrombus in further accelerating pulse-spray
pharmacomechanical thrombolysis (PSPMT) with urokinase (UK) or tissue
plasminogen activator (tPA) in a rabbit model. MATERIALS AND METHODS:
With use of a subacute rabbit inferior vena cava (IVC) thrombosis mod
el, 78 rabbits were divided into eight groups according to the agents
used for thrombolysis: (i) controls (IVC thrombosis, no lysis performe
d), (ii) pulse-spray thrombolysis with saline only, (iii) PSPMT with U
K, (iv) PSPMT with UR, plus interim pulse-spray plasminogen enrichment
after 14 minutes, (v) pulse-spray plasminogen enrichment, followed at
10 minutes by PSPMT with UK, (vi) PSPMT with tPA, (vii) PSPMT with tP
A, plus interim plasminogen enrichment, and (viii) pulse-spray plasmin
ogen enrichment, followed at 10 minutes by PSPMT with tPA. RESULTS: In
trathrombic pulsed injection of glu-plasminogen after 14 minutes of tP
A PSPMT demonstrated significant augmentation of lysis (similar to 31%
decrease in residual thrombus) compared with tPA alone (P = .006). Ly
sis was not augmented significantly when plasminogen was sprayed into
thrombus before tPA, or before or after UR. CONCLUSION: Plasminogen en
richment of thrombus after onset of PSPMT with tPA significantly accel
erated thrombolysis in a subacute in vivo rabbit model. A clinical tri
al of this method may be warranted.