Heymans S, Verhaeghe R, Stockx L, Collen D
Center for Molecular and Vascular Biology, University of Leuven, Belgium.
Thromb Haemost. 1998 Mar;79(3):517-9.
The feasibility of catheter-directed thrombolysis with recombinant staphylokinase was evaluated in six selected patients with deep vein thrombosis. The patients underwent intrathrombus infusion of recombinant staphylokinase (2 mg bolus followed by a continuous infusion of 1 mg/h). Heparin was given via the catheter as a bolus (5000 U) and as a continuous infusion (1000 U/h). Complete lysis was obtained in five patients and partial lysis in one patient. Complications consisted of minor bleeding in four subjects. Symptomatic reocclusion occurred in one. Debulking of the thrombus mass by a high speed rotating impeller (n = 1) and stenting (n = 3) were used as additional interventions. An underlying anatomical abnormality was present in two patients. Long term follow up revealed normal patency in all patients and normal valve function in four patients. Symptomatic venous insufficiency with valve dysfunction was present in the two with a second thrombotic episode. Thus catheter-directed infusion of recombinant staphylokinase in patients with deep vein thrombosis appears feasible and may be associated with a high frequency of thrombolysis. Larger studies to define the clinical benefit of this treatment appear to be warranted.
对6例选定的深静脉血栓形成患者评估了导管定向重组葡萄球菌激酶溶栓的可行性。患者接受重组葡萄球菌激酶的血栓内输注（2mg推注，随后以1mg/h持续输注）。通过导管给予肝素推注（5000U）和持续输注（1000U/h）。5例患者实现完全溶解，1例患者部分溶解。并发症包括4例受试者出现轻微出血。1例发生有症状的再闭塞。通过高速旋转叶轮（n = 1）减容血栓块和置入支架（n = 3）作为额外干预措施。2例患者存在潜在的解剖学异常。长期随访显示所有患者通畅正常，4例患者瓣膜功能正常。2例发生第二次血栓形成事件的患者存在伴有瓣膜功能障碍的有症状静脉功能不全。因此，对深静脉血栓形成患者进行导管定向重组葡萄球菌激酶输注似乎可行，且可能与高频率溶栓相关。开展更大规模研究以明确该治疗的临床益处似乎是有必要的。
