Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urokinase treatment, previously employed with success in the declotting of deep venous thrombosis and arteriovenous shunts in patients undergoing regular dialytic treatment (RDT), was used in 23 cases of arteriovenous fistula thrombotic occlusion in 18 RDT patients. The treatment was successful in 65.2% of the cases without any negative side effects, except 1 case which may have developed a pulmonary embolism. Patients with severe hypofibrinolysis may need larger doses or may have a recurrence of the thrombotic episode. All therapeutic failures correlated with the presence of fibrosis or sclerosis.
 ...
PMID:Urokinase treatment for arteriovenous fistulae declotting in dialyzed patients. 669 Oct 3

30 patients with deep vein thrombosis were treated with a combination of urokinase and heparin. Clinically relevant improvement was achieved in 2/3 of them with appr. 40,000 IU/h (1,000,000 IU/d) urokinase administered over a period of several days. This indicates that urokinase at this dosage offers a valuable alternative or supplementation to fibrinolytic therapy with streptokinase. With the dosage employed, routine blood coagulation tests are only minimally affected, although a strong enhancement of fibrinolytic activity can be demonstrated by the euglobulin clot lysis time. Plasminogen depletion - as is usually observed with streptokinase therapy - does not occur. Urokinase is well tolerated and there is only a very moderate bleeding tendency. The cost per day of urokinase therapy at the dosage employed is approximately twice that of customary streptokinase therapy.
 ...
PMID:[Urokinase therapy of deep vein thrombosis (author's transl)]. 699 73

Urokinase and streptokinase are the two fibrinolytics approved for clinical use. Streptokinase has the broader application, being used to treat deep vein thrombosis (DVT), pulmonary embolism (PE), arterial thromboembolism, and occluded arteriovenous shunts in renal dialysis. Bleeding, the most significant complication of fibrinolytic therapy, arises mostly from invaded sites and can be significantly reduced by minimizing venipuncture and other invasive procedures.
 ...
PMID:Fibrinolytic guidelines in diabetes. 706 Sep 47

The history and physical examination were assessed in 215 patients with acute pulmonary embolism uncomplicated by preexisting cardiac or pulmonary disease. The patients had been included in the Urokinase Pulmonary Embolism Trial or the Urokinase-Streptokinase Embolism Trial. Presenting syndromes were (1) circulatory collapse with shock (10 percent) or syncope (9 percent); (2) pulmonary infarction with hemoptysis (25 percent) or pleuritic pain and no hemoptysis (41 percent); (3) uncomplicated embolism characterized by dyspnea (12 percent) or nonpleuritic pain usually with tachypnea (3 percent) or deep venous thrombosis with tachypnea (0.5 percent). The most frequent symptoms were dyspnea (84 percent), pleuritic pain (74 percent), apprehension (63 percent) and cough (50 percent). Hemoptysis occurred in only 28 percent. Dyspnea, hemoptysis or pleuritic pain occurred separately or in combination in 94 percent. All three occurred in only 22 percent. The most frequent signs were tachypnea (respiration ate 20/min or more) (85 percent), tachycardia (heart rate 100 beats/min or more) (58 percent), accentuated pulmonary component of the second heart sound (57 percent) and rales (56 percent). Signs of deep venous thrombosis were present in only 41 percent and a pleural friction rub was present in only 18 percent. Either dyspnea or tachypnea occurred in 96 percent. Dyspnea, tachypnea or deep venous thrombosis occurred in 99 percent. As a group, the identified clinical manifestations, although nonspecific, are strongly suggestive of acute pulmonary embolism. Conversely, acute pulmonary embolism was rarely identified in the absence of dyspnea, tachypnea or deep venous thrombosis.
 ...
PMID:History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease. 746 69

There is a well known relationship between factor XII deficiency and arterial and venous thrombosis. A new case of moderate factor XII deficiency associated to spontaneous deep vein thrombosis and treated with Urokinase is reported. The patient had a partial response to the treatment with Urokinase, with normal study of the fibrinolytic system. The deficiency was found in five relatives within the three generations studied. The genetic transmission had an autosomic dominant pattern. We feel that there is no relationship between the family history or the degree of factor XII deficiency and the risk of developing deep venous thrombosis.
 ...
PMID:[Congenital deficiency of factor Xii and spontaenous venous thrombosis treated with urokinase]. 757 Feb 75

The AA. utilized temporary vena cava filters (16 Filcard and 8 Lysofilters) in 24 patients affected by deep venous thrombosis (DVT) of the lower limbs for the prevention of primary and recurrent pulmonary embolism (PE). The diagnosis of thromboembolic disease was always achieved by means of Ultrasounds (echo-color doppler) and was punctually confirmed by a retrograde cavagram during the insertion of the device. 19 patients presented large free-floating thrombi at inferior caval, iliac or common femoral vein level whereas 5 patients presented thrombi mostly of occlusive aspect. There was clinical or scintigraphic evidence of PE in 6 of the patients enrolled. 20 patients, without contraindications, were treated by fibrinolysis (F) with Urokinase (2-10 days) whereas 4 patients underwent surgical thrombectomy (T) because of short time relation with surgical intervention or trauma. All of them were protected by temporary vena cava filters and heparinized. All the filters were removed within 10 days. The results were considered "very good" (complete regression of floating thrombi) in 16 cases (14 F + 2 T), "good" (nearly complete regression of floating thrombi) in 3 cases (2 F + 1 T) and "poor" (unchanged) in the remaining 5 cases (4 F + 1 T). We didn't observe any new case or relapse of PE in the whole group and, furtherly, in 2 cases (1 F and 1 T) we demonstrated the capture of big emboli by the filter's basket. These clots were subsequently dissolved by fibrinolysis. To achieve the diagnosis of thromboembolic disease the following methods were used: 1--Screening: echo-color doppler of lower limbs extended to iliac and inferiora cava veins for detection of DVT and echocardio-color doppler for the detection of cardiac signs of PE. 2--DIAGNOSIS: pulmonary scintigram, retrograde cavogram and, rarely, angioCT scan. 3--FOLLOW-UP: echo-color doppler of lower limbs and pulmonary scintigram. The percutaneous insertion sites were the basilic vein (Filcard) and the right jugular vein (Lysofilter). Left jugular vein was used in 1 case with a big thyroid goitre. In the present experience we had no accidents during filters introduction or removal and no thrombosis at the insertion site (1 case of phlebitis of basilic vein). Indications and effectiveness: our results seem to be favorable to the use of inferior vena cava temporary filters for primary and recurrent pulmonary embolism prevention in the cases with floating thrombi both on fibrinolysis and embolectomy. In the cases of occlusive thrombotic diseases they proved to be effective to prevent PE during surgical embolectomy.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Temporary caval filters. Our experience. Preliminary analysis of 24 cases]. 824 12

The combination of catheter-directed thrombolytic therapy and endovascular stenting is a new and promising approach for treating acute and chronic thrombotic iliofemoral venous occlusions on the basis of the authors' initial experience in a small group of patients. In acute DVT, catheter-directed techniques provide more complete lysis than systemic infusions and early, aggressive interventional therapy may spare the patient from the life-long disability associated with the postphlebitic syndrome, by preserving valve function and eliminating the venous outflow obstruction. Immediate postthrombolysis venography can evaluate the underlying vein and assess the need for adjunctive treatment with angioplasty and/or stents. Urokinase has a high degree of safety with few complications when a catheter-directed approach rather than systemic infusion is used. Even patients with chronic DVT can benefit by reducing the obstruction to venous outflow if the occlusion is limited to the iliac vein and/or the inferior vena cava. Long-term follow-up studies are necessary to evaluate patency rates of the treated veins, determine whether successfully treated limbs have a lower frequency of recurrent DVT, and ascertain the frequency of chronic venous insufficiency compared with that in patients treated with anticoagulation alone. Based on our initial experience, a National Venous Thrombosis Registry was established in October 1994. The purpose of this multidisciplinary Registry is to prospectively document the long-term results of catheter-directed thrombolytic therapy for patients with iliofemoral DVT, with data now being collected from 40 leading medical centers around the United States. We hope that endovascular techniques for iliofemoral DVT will significantly reduce the immediate and long-term complications commonly associated with this difficult and often misunderstood clinical problem.
 ...
PMID:Catheter-directed thrombolysis for iliofemoral venous thrombosis. 866 23

The treatment of choice in acute deep vein thrombosis continues to be controversial. Conservative treatment with heparin and anticoagulation, systemic thrombolysis, thrombectomy and the combination of local thrombolysis and surgical unblocking are possible therapies. Regarding long term results; both after non operative treatment or after venous thrombectomy, many authors describe a majority of patients who suffer from chronic venous insufficiency in varying clinical severity. Requirements for normal venous function are complete phlebographic patency and valvular competence without venous reflux. Our proposed treatment for thromboses not older than 7 days combines local thrombolysis with venous thrombectomy to achieve these requirements and contains the following operative proceeding: An incision is made in the groin or - for more distal thromboses - on the proximal end of the clot. For the removal of the clot in the iliac vein a Fogarty-catheter is used. Urokinase is administered through a vein puncture in the instep while the blood flow is blocked by a pneumatic cuff around the thigh. After at least 20-30 minutes the clots can be removed through the proximal incision after removal of the cuff and manual massage of the leg. During this procedure the vein proximal of the venotomy is occluded by a soft clamp. An analysis of the results of 34 patients on average 3 1/2 years after combined therapy confirms normal valvular function of the popliteal vein in 27 (79%) cases. This improved long term outcome is going to be checked in an prospective study evaluating anticoagulation versus our treatment concept.
 ...
PMID:[Treatment concept in deep pelvic-leg venous thrombosis]. 868 Nov 21

Bolus urokinase (Abbokinase ) is effective for initial treatment of deep venous thrombosis but is associated with a high rate of rigors. This randomized controlled trial was undertaken among patients with deep venous thrombosis to evaluate the efficacy and safety of a novel thrombolytic agent, recombinant urokinase (rUK), administered as three bolus infusions of 1 million U over a 24-hour period versus heparin alone. Of 361 patients with DVT screened, 17 (5%) were enrolled. Recent surgery was the most common reason for exclusion (n = 113, 31%). Images of the patients were obtained at baseline, 24 to 48 hours after randomization, and before hospital discharge. Two patients in each treatment group had minor clot progression. One patient in the heparin group had no change; all other patients showed mild (< 50%; n = 5 in each group) or moderate (> 50%; n = 1 in each group) improvement. No bleeding complications or rigors developed in patients randomized to rUK. Mean bleeding times among patients given rUK were not significantly different from mean values of patients given heparin at any of the measured time points available for comparison (331 vs 387 seconds at baseline and 381 vs 416 seconds at 24 hours). However, mean fibrinogen levels declined with successive urokinase boluses and were significantly lower than levels in patients treated with heparin at 24 (233 mg/dl vs 466 mg/dl, p = 0.01) and 48 hours (270 mg/dl vs 474 mg/dl, p = 0.02). Although bolus rUK had a favorable safety profile, rUK was no more effective than heparin in achieving clot lysis at the doses used in this trial.
 ...
PMID:Bolus recombinant urokinase versus heparin in deep venous thrombosis: a randomized controlled trial. 870 92

A number of recent data suggest that mast cells (MC) and their products are involved in the pathophysiology of thrombosis. In the current study, we have evaluated the number, distribution, and phenotype of MC in patients with deep vein thrombosis of the lower limb (DVT) (n = 15). Contralateral nonthrombosed limb veins served as control (CO). MC were examined by Giemsa staining and by immunohistochemistry using antibodies against tryptase, chymase, tissue-type plasminogen activator (tPA), urokinase (uPA), urokinase receptor (uPAR), and plasminogen activator inhibitors (PAI-1, PAI-2). We found an increase in the number of tryptase-positive MC in DVT compared with CO (DVT: 9.1+/-1.0 v CO: 4.7+/-0.6 MC/mm2, P < .05). Most of these MC appeared to accumulate in the adventitia of the thrombosed veins, in vicinity of the vasa vasorum. In both DVT and CO, MC reacted with monoclonal antibodies to c-kit, tryptase, and chymase. MC also stained positive for tPA and urokinase receptor, but did not express detectable PAI-1 or PAI-2. As compared with CO, a decreased proportion of MC in DVT was found to stain positive for chymase and tPA. Together, our results show that MC increase in number in DVT and express a profibrinolytic phenotype. We hypothesize that MC and MC-derived profibrinolytic molecules play a role in the pathophysiology of DVT.
 ...
PMID:Mast cells are augmented in deep vein thrombosis and express a profibrinolytic phenotype. 1002 47


<< Previous 1 2 3 Next >>