AI Article Synopsis
- The study measured the binding of indium-111-labeled rt-PA after PTA and thrombolysis in different patient groups with varying occlusion types.
- In patients with long occlusions, more rt-PA was binding and had a longer washout time compared to those with multiple or single stenoses, indicating a significant difference in fibrin presence.
- The findings suggest that increased rt-PA accumulation is linked to greater fibrin levels in more severe lesions, which could contribute to early treatment failures and might be improved by targeting fibrin removal during therapy.
Article Abstract
The authors measured the binding of indium-111-labeled recombinant tissue-type plasminogen activator (rt-PA) within the recanalized femoropopliteal segment after percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis. In patients with long occlusions (n = 3), 91 micrograms of rt-PA was bound 1 hour after the procedure, and the half-time of the final washout curve averaged 114 hours. After PTA in patients with multiple stenoses (n = 6), 45 micrograms of rt-PA was bound, and the half-time averaged 32 hours. These values were significantly smaller than those in patients with occlusions (P < .01). In patients with a single stenosis (n = 4), 19 micrograms of rt-PA was bound, and the half-time averaged 5 hours. These values were significantly smaller than those in patients with multiple stenoses (P < .01). The progressive accumulation of rt-PA at the sites of PTA therapy is most likely related to increasing presence of fibrin with increasing lesion severity. Fibrin accumulation may be partly responsible for early failures after PTA in extensive lesions. Removal of this fibrin with enclosed thrombolysis might improve patency.
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| http://dx.doi.org/10.1016/s1051-0443(92)72908-x | DOI Listing |
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