[Use of urokinase in the occlusion of the vascular access routes in chronic hemodialysis. 7 years' experience].

Pharmacological treatment with urokinase in obstructions of vascular accesses due to chronic dialysis is a tried and tested technique. Retrospective investigation of a group of 111 cases treated with urokinase makes it possible to calculate the actuarial survival curve of vascular access in the period subsequent to fibrinolytic treatment. Mathematical analysis provides a precise indication to the use of the drug in thromboses of a-v fistulas and anatomically unimpaired vascular prothesies. In the presence of stenosis of a-v anastomosis, pharmacological thrombolysis permits restoration of a blood flow suitable to the conduction of haemodialytic treatment for a period useful to surgical correction. Infusion of urokinase is useless in cases of vascular prosthesis thrombosis complicated by the presence of stenosis of the lumen.