Systemic fibrinolytic treatment of chronic arterial occlusion in the elderly

International Journal of Angiology - Tập 4 - Trang 182-187 - 1995
Michael Martin1, Thomas Heimig1, Kurt Henrich1
1Geriatric Department, Städ Kliniken, Duisburg, Germany

Tóm tắt

Systemic fibrinolytic therapy is effective in dissolving chronic arterial occlusions. In the present study, ultra-high streptokinase short-term lysis was the treatment of choice. It consisted of one to three infusion series of 9 million IU SK over 6 hours each. In about 50% of patients, a subsequent catheter dilation was carried out either for widening residual stenoses or for clearance of vessels still occluded. Patients treated were 176 younger than 65 years and 165 older. Targets of therapy were iliac and femoral occlusions; iliac occlusions were removed more often in older patients and femoral occlusions more often in younger patients. The rate of cerebral bleeding was 1.14% in the younger and 0.606% in the older patient group. No age-related differences existed for streptokinase plasma concentrations and streptokinase half-life. Plasminogen, on the other hand, which fell during streptokinase infusion to below 10% recovered more slowly in the older than in the younger patients.

Tài liệu tham khảo

Martin M, Fiebach BJO (1991) Short-term ultrahigh streptokinase treatment of chronic arterial occlusions and acute deep vein thrombosis. Semin Thromb Hemost 17:21–38. Alexander H, Buhl O, Holsten D, Poliwoda H, Wagner HH (1968) Fibrinolytische Therapie des chronischen Arterienverschlusses. Med Klin 63:2067–2070. Ehringer H, Fischer M (1968) Erfolgreiche thrombolytische Therapie bei subakuten arteriellen Thrombosen. Med Welt 1726–1730. Kaindl F, Pilgerstorfer HW, Weidinger P, Fischer M (1968) Untersuchungen zur Thrombolyse älterer arteriellerr Verschlüsse mit Streptokinase-Therapie. Med Welt 1731–1733. Schoop W, Martin M, Zeitler E (1968) Beseitigung alter Arterienverschlüsse durch intravenöse Streptokinaseinfusion. Dtsch med Wschr 93:2312–2324. Deutsch E, Ehringer H (1972) Thrombolytic therapy in chronic arterial occlusions. J Clin Pathol 25:644–645. Heinrich F, Schmutzler R (1972) Ergebnisse der Thrombolysebe-handlung chronischer Gliedmaßenarterienverschlüsse. Dtsch med Wschr 23:351–358. Le Veen HH, Diaz CA (1972) Venous and arterial occlusive disease treated by enzymatic clot lysis. Arch Surg 105:927–936. Martin M (1982) Streptokinase in chronic arterial disease. CRC Press: Boca Raton, pp 59–67. Persson AV, Thomson JE, Patman D (1973) Streptokinase as an adjunct to arterial surgery. Arch Surg 107:779–784. Martin M, Fiebach BJO (1994) Fibrinolytische Behandlung peripherer Arterien- und Venenverschlüsse. Verlag Hans Huber: Bern-Stuttgart-Toronto, pp 64–65, 73–79. Spengel FA, Anton B, Knüffer G (1991) Ultrahohe systemische Lyse bei Strombahnhindernissen der Aorta und A. iliaca bei 14 Patienten. VASA 20 (suppl):33, 128. Martin M, Fiebach BJO, Feldkamp M (1983) Ultrahole Streptokinase-Infusionsbehandlung bei peripheren Gefäßverschlüssen. Dtsch med Wschr 108:167–171.