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Radiology, Vol 178, 681-686, Copyright © 1991 by Radiological Society of North America

ARTICLES

Two urokinase dose regimens in native arterial and graft occlusions: initial results of a prospective, randomized clinical trial

AH Cragg, TP Smith, JD Corson, N Nakagawa, F Castaneda, TF Kresowik, WJ Sharp, A Shamma and KS Berbaum
Department of Radiology, University of Iowa College of Medicine, Iowa City.

The effects of two urokinase (UK) dose regimens on lysis time, lytic success, primary clinical success, and frequency of complications of peripheral thrombolysis were compared. Seventy-two intraarterial UK infusions were performed by means of standard catheter-directed infusion techniques in 63 patients with symptomatic peripheral arterial or bypass graft occlusions. Patients were prospectively randomized to high-dose (250,000 U/h for 4 hours and then 125,000 U/h) or low-dose (50,000 U/h) regimens. The mean time to complete lysis was 20.8, 26.0, 16.5, and 18.2 hours for the high-dose artery, low-dose artery, high- dose graft, and low-dose graft groups, respectively (P was not significant). Respective mean infusion durations were 27.1, 35.4, 22.2, and 25.3 hours. Clinical success was achieved in 65%-85% of cases. The frequency of complications was equivalent between groups, except for a higher frequency of minor bleeding complications in the high-dose group. The two urokinase dose regimens studied were equally effective in enabling peripheral thrombolysis.


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