Trerotola S O, Johnson M S, Schauwecker D S, Davidson D D, Filo R S, Zhou X H, Eckert G J, Dreesen R G, Carlson K A, Forney M
Department of Radiology, University Hospital 0279, Indiana University Medical Center, Indianapolis 46202-5253, USA.
Radiology. 1996 Jul;200(1):169-76. doi: 10.1148/radiology.200.1.8657906.
To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts.
Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary-artery pressure measurements, and pulmonary arteriography were performed before and after each procedure.
A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group.
The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.
比较脉冲喷射药物机械溶栓（PSPMT）和用于清除透析通路移植物血栓的机械溶栓所导致的肺栓塞情况。
在8只犬身上建立聚四氟乙烯动静脉分流，并每月故意使其形成血栓。将动物随机分为接受脉冲喷射尿激酶溶栓治疗组或低速旋转经皮溶栓装置治疗组。在每次操作前后进行灌注成像、肺动脉压力测量和肺动脉造影。
共进行了22次操作（11次PSPMT和11次机械溶栓）。所有操作中血栓清除均成功，30天通畅率为100%。11次PSPMT操作中的10次（91%）和11次机械溶栓操作中的2次（18%）在灌注图像上出现节段性缺损（P <.002）。PSPMT组出现肺动脉压力短暂升高。所有病例中栓子均完全溶解且压力恢复至基线水平，即使在同一动物身上进行多次（最多4次）操作后也是如此。两组均无肺梗死的组织学证据。
经皮溶栓装置对犬透析移植物血栓清除有效，与PSPMT相比，导致的肺栓塞在统计学上显著减少。
