High-Dose, Short-Term Local Urokinase for Clearing Femoral Thrombi by Vasodilation and Thrombolysis.

摘要

It was previously reported that human urine urokinase caused a dose-dependent increase in femoral arterial blood flow when injected intra-arterially. The application of this finding to the clinical situation requires demonstration of efficacy. Femoral arterial blood flow was measured electromagnetically in 8 mongrel dogs under pentobarbital anesthesia. Two preparations of urokinase were infused intra-arterially for 5 minutes: ploug and abbott. Control femoral arterial blood flow was 140 plus or minus 20 ml/min. Ploug urokinase at 10 units/kg/min significantly increased blood flow above control by 121 plus or minus 22 ml/min at one minute. By 5 min the increase in flow was 49 plus or minus 12 ml/min which was still significantly higher than control. Abbott urokinase also increased flow: this increase in flow at one minute was 26 plus or minus 12 ml/min at 100 and 66 plus or minus 12 ml/mm at 1000 units/kg/min. The fibrinolytic activity of peripheral blood, as measured by the area of lysis on fibrin plates, was significantly enhanced by the infused urokinase from a control value of 395 plus or minus 76 sq mm to 623 plus or minus 31 sq mm. Epsilon aminocaproic acid, an inhibitor or plasminogen activation, prevented this increase in fibrinolytic activity but not the vasodilator effects. One -two day old thrombi were produced bilaterally in the femoral arteries of 7 dogs resulting in obstruction in 12/14 limbs. Local ia infusion of abbott urokinase at 100 units/kg/min for 100 min lysed all clots demonstrated arteriographically and returned blood flow in obstructed limbs to more than 50 percent of control values on the infused side but not on the contralateral side.