Valji K, Bookstein J J
Invest Radiol. 1987 Jan;22(1):23-7. doi: 10.1097/00004424-198701000-00003.
The efficacy of intrathrombic deposition vs. parathrombic infusion of urokinase (UK) and tissue-type plasminogen activator (t-PA) was investigated in a canine model. Gianturco coils were placed by transcatheter techniques into the iliac veins of 12 dogs. Venography obtained 48 hours later showed formation of large thrombi. After heparinization, UK (24,000-48,000 IU/ml) or t-PA (12,500-25,000 IU/ml) was spray-injected at high pressure throughout test clots every half-hour using a steel catheter with multiple side holes. Between injections, the agent was infused below the clots. The contralateral thrombi received an equivalent dose of fibrinolytic agent by continuous infusion. In six cases, plasminogen was injected into test clots prior to activator treatment. Thrombi spray-injected with either activator lysed in 64 +/- 26 minutes. Four of six thrombi treated with parathrombic urokinase infusion showed partial lysis after 133 +/- 50 minutes. After parathrombic infusion of t-PA, three clots showed complete lysis, one showed partial lysis, and two demonstrated no lysis. There was no significant difference in lysis rate between intrathrombic UK and t-PA nor did prior intrathrombic injection of plasminogen accelerate lysis. In summary, intrathrombic injection of highly concentrated UK or t-PA lysed subacute thrombi more effectively than parathrombic infusion.
在犬模型中研究了尿激酶（UK）和组织型纤溶酶原激活剂（t-PA）的血栓内沉积与血栓旁注入的疗效。通过经导管技术将Gianturco线圈置于12只犬的髂静脉内。48小时后进行静脉造影显示形成了大血栓。肝素化后，使用带有多个侧孔的钢导管每半小时在整个试验性血栓处以高压喷雾注射UK（24,000 - 48,000 IU/ml）或t-PA（12,500 - 25,000 IU/ml）。两次注射之间，将药物注入血栓下方。对侧血栓通过持续输注接受等量的纤溶药物。在6例中，在激活剂治疗前将纤溶酶原注入试验性血栓中。用任何一种激活剂喷雾注射的血栓在64±26分钟内溶解。6例接受血栓旁尿激酶注入治疗的血栓中有4例在133±50分钟后出现部分溶解。血栓旁注入t-PA后，3个血栓完全溶解，1个部分溶解，2个未溶解。血栓内UK和t-PA之间的溶解率无显著差异，血栓内预先注射纤溶酶原也未加速溶解。总之，高浓度UK或t-PA的血栓内注射比血栓旁注入更有效地溶解亚急性血栓。
