Admixture of heparin with urokinase to decrease thrombolysis time and urokinase dose in polytetrafluoroethylene dialysis graft recanalization.

PURPOSE

To determine whether the addition of heparin to urokinase during dialysis graft thrombolysis can lower urokinase dose and shorten procedure time.

PATIENTS AND METHODS

Patients who underwent dialysis graft thrombolysis during an 18-month period were studied retrospectively. Twenty patients were treated with urokinase alone, and 19 patients were treated with urokinase and heparin. Thrombolysis was performed in the angiography suite by using a crossed-catheter technique. Urokinase was administered directly into the thrombus. In patients receiving heparin, 5,000 IU was added directly to the initial urokinase solution.

RESULTS

In patients who received urokinase alone, an average of 750,000 U of urokinase was used, and the average procedure time was 2 hours 42 minutes. When heparin was added, an average of 435,000 U of urokinase was used, and the average procedure time was 2 hours.

CONCLUSION

The addition of heparin to urokinase can decrease both urokinase dose and thrombolysis time in the recanalization of dialysis grafts.