Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.21.73 (urokinase-type plasminogen activator)
 10,685 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because a popliteal artery aneurysm (PAA) generates emboli that progressively deteriorate the distal arterial network, they can constitute limb-threatening lesions. In 20 to 40% of cases, discovery of PAA coincides with sudden occlusion and resulting acute ischemia. In 40 to 60% of these patients, surgical revascularization fails and amputation is required. The objective of this prospective study was to assess the value of intraarterial thrombolysis to restore distal runoff before surgical revascularization. Between January 1, 1992 and December 31, 1996, we treated 15 PAA causing acute ischemia in 15 male patients with a mean age of 66.7 years (range, 44 to 87 years). Diagnosis was documented by clinical examination and ultrasound imaging. Intraarterial thrombolysis was performed under arteriographic control through a multiperforated catheter inserted by the anterograde femoral route to the thrombus. After an initial bolus of 100,000 U of urokinase, 600,000 to 1,600,000 U was continuously infused over a period of 6 to 18 hr. Heparin sodium was administered throughout thrombolysis. Surgical revascularization was performed within 1 to 4 days (mean, 2 days) after thrombolysis by exclusion and bypass in 14 cases and percutaneous transluminal angioplasty with stenting in 1 case. The ensuing results showed that, if performed carefully, intraarterial thrombolysis can safely prepare patients presenting with occluded PAA with acute ischemia for surgical revascularization to restore distal runoff. We use this combined technique routinely in our department. Morbidity is low in comparison with the risks of amputation.
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PMID:Preoperative intraarterial thrombolysis before surgical revascularization for popliteal artery aneurysm with acute ischemia. 1094 88

A 63-year-old man was admitted to a hospital for sudden loss of consciousness. Chest computed tomography (CT) revealed massive pulmonary thromboembolism. Heparin sodium and urokinase were administered, but were not effective. He was then referred to our hospital. His oxygen saturation was 88% in room air. Due to presence of severe hypoxemia and ineffectiveness of the antithrombotic therapy, thrombectomy was done under extracorporeal circulation. Postoperative course was uneventful, and he was discharged on the 24 th postoperative day. Oxygen saturation on discharge was 98% in room air. In conclusion, thrombectomy of subacute pulmonary thromboembolism was performed successfully under extracorporeal circulation.
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PMID:[Thrombectomy of subacute pulmonary thromboembolism under extracorporeal circulation: report of a case]. 1678 68