Tønnesen K H, Vinberg N, Folkenborg O
Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
J Vasc Interv Radiol. 1992 Nov;3(4):627-32. doi: 10.1016/s1051-0443(92)72908-x.
The authors measured the binding of indium-111-labeled recombinant tissue-type plasminogen activator (rt-PA) within the recanalized femoropopliteal segment after percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis. In patients with long occlusions (n = 3), 91 micrograms of rt-PA was bound 1 hour after the procedure, and the half-time of the final washout curve averaged 114 hours. After PTA in patients with multiple stenoses (n = 6), 45 micrograms of rt-PA was bound, and the half-time averaged 32 hours. These values were significantly smaller than those in patients with occlusions (P < .01). In patients with a single stenosis (n = 4), 19 micrograms of rt-PA was bound, and the half-time averaged 5 hours. These values were significantly smaller than those in patients with multiple stenoses (P < .01). The progressive accumulation of rt-PA at the sites of PTA therapy is most likely related to increasing presence of fibrin with increasing lesion severity. Fibrin accumulation may be partly responsible for early failures after PTA in extensive lesions. Removal of this fibrin with enclosed thrombolysis might improve patency.
作者们测量了经皮腔内血管成形术（PTA）和封闭溶栓术后，铟 - 111标记的重组组织型纤溶酶原激活剂（rt - PA）在再通的股腘段内的结合情况。在患有长段闭塞的患者（n = 3）中，术后1小时有91微克的rt - PA发生结合，最终洗脱曲线的半衰期平均为114小时。在患有多处狭窄的患者（n = 6）中进行PTA后，有45微克的rt - PA发生结合，半衰期平均为32小时。这些值显著小于患有闭塞的患者（P <.01）。在患有单一狭窄的患者（n = 4）中，有19微克的rt - PA发生结合，半衰期平均为5小时。这些值显著小于患有多处狭窄的患者（P <.01）。rt - PA在PTA治疗部位的逐渐积累很可能与随着病变严重程度增加纤维蛋白的存在增多有关。纤维蛋白的积累可能部分导致了广泛病变中PTA术后的早期失败。通过封闭溶栓去除这种纤维蛋白可能会改善血管通畅情况。
