Urokinase Treatment In Acute And Subacute Deep Vein Thrombosis

1981 ◽  
Author(s):  
G Trübestein ◽  
Th Brecht ◽  
M Ludwig ◽  
G Brecht ◽  
F Etzel
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Side Effects ◽  
Initial Dose ◽  
Fibrinolytic Therapy ◽  
Thrombin Time ◽  
Vein Thrombosis ◽  
The Uk ◽  
Deep Vein ◽  
Medium Dose

So far 74 patients with acute and subacute Deep Vein Thrombosis (DVT) were treated with a standardized Urokinase (UK) heparin scheme. From these patients 19 patients had a 1-6 day and 55 patients a 1-6 week old thrombosis of the iliac, femoral, popliteal or subclavian veins. The initial dose of the UK regimen was mostly 250.000 IU UK/10 min; the maintenance dose was 1.000.000 IU UK/24h in 40 patients, 1.500.000 IU UK/24h in 12 patients and 2.000.000 IU UK/24h in 22 patients. Heparin was given from the very beginning, starting with a dose of 1.000 IU/h. In the further course of therapy heparin was adjusted so that the thrombin time was 2 to 4 times of the normal. The duration of fibrinolytic therapy was mostly between 3 and 6 days in acute and between 7 and 14 days in subacute DVT. Severe side effects were seen in 2 patients, who had a strong bleeding. One patient died of pulmonary embolism.Results: The 1-6 day old thromboses of the 19 patients could be dissolved completely in 7 patients (37%) and partially in 4 patients (21%); no amelioration in the phlebo- grams was found in 8 patients (42%). The 1-6 week old thromboses of the 55 patients could be dissolved completely in 9 patients (16%) and partially in 30 patients (55%); no amelioration in the phlebograms was found in 16 patients (29%).Conclusion: The standardized UK-heparin scheme with a medium dose 80.000 IU UK/h used by us proved to be effective in most patients with DVT.

FIBRINOLYTIC THERAPY WITH STREPTOKINASE AND UROKINASE IN DEEP VEIN THROMBOSIS

1987 ◽  
Author(s):  
G Trübestein ◽  
M Ludwig ◽  
M Wilgalis ◽  
R Trübestein ◽  
S Popov
Keyword(s):  
Deep Vein Thrombosis ◽  
Fibrinolytic Therapy ◽  
Vein Thrombosis ◽  
Complete Recanalisation ◽  
Group A ◽  
Acute Deep Vein Thrombosis ◽  
The Uk ◽  
Deep Vein ◽  
Heparin Dosage ◽  
Deep Vein Thromboses

336 patients with acute 1-6 day old, and subacute, 1-3 week old deep vein thrombosis were treated with streptokinase (SK) or urokinase (UK) up to April 1, 1985. 175 patients were included in the SK group, 161 patients in the UK group. A standardized SK-heparin and the standardized UK-heparin dosage scheme with 100.000 IU SK/h or 100.000 IU UK/ h were used. In patients with acute deep vein thrombosis a complete recanalisation could be achieved in 67% and a partial recanalisation in 25% with the standardized SK scheme; a complete recanalisation could be achieved in 46%, and a partial recanalisation in 30% with the standardized UK scheme.Since April 1, 1985 we use the ultra high SK dosage scheme, with an initial dose of 250.000 IU SK/h and a maintenance dose of 1.500.000 IU SK/h over.6 hours. So far 28 patients were treated in this way. The results show, that with an ultra high SK-dosage scheme a complete recanalisation could be achieved in 46% and a partial recanalisation in 25% in 1-6 day old deep vein thromboses. The results of both the SK schemes and the UK scheme are discussed in accordance with the haemostaseologica1 parameters.

scholarly journals GPs’ familiarity with and use of cardiovascular clinical prediction rules: a UK survey study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101081
Author(s):  
Jong-Wook Ban ◽  
Rafael Perera ◽  
Richard Stevens
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Survey Study ◽  
Risk Scores ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Vein Thrombosis ◽  
The Uk ◽  
Deep Vein

BackgroundClinical prediction rules (CPRs) can help general practitioners (GPs) address challenges in cardiovascular disease. A survey published in 2014 evaluated GPs’ awareness and use of CPRs in the UK. However, many new CPRs have been published since and it is unknown which cardiovascular CPRs are currently recognised and used.AimTo identify cardiovascular CPRs recognised and used by GPs, and to assess how GPs’ familiarity and use have changed over time.Design & settingAn online survey of GPs in the UK was undertaken.MethodUsing comparable methods to the 2014 survey, GPs were recruited from a network of doctors in the UK. They were asked how familiar they were with cardiovascular CPRs, how frequently they used them, and why they used them. The results were compared with the 2014 survey.ResultsMost of 401 GPs were familiar with QRISK scores, ABCD scores, CHADS scores, HAS-BLED score, Wells scores for deep vein thrombosis, and Wells scores for pulmonary embolism. The proportions of GPs using these CPRs were 96.3%, 65.1%, 97.3%, 93.0%, 92.5%, and 82.0%, respectively. GPs’ use increased by 31.2% for QRISK scores, by 13.5% for ABCD scores, by 54.6% for CHADS scores, by 33.2% for Wells scores for deep vein thrombosis, and by 43.6% for Wells scores for pulmonary embolism; and decreased by 45.9% for the Joint British Societies (JBS) risk calculator, by 38.7% for Framingham risk scores, and by 8.7% for New Zealand tables. GPs most commonly used cardiovascular CPRs to guide therapy and referral.ConclusionThe study found GPs’ familiarity and use of cardiovascular CPRs changed substantially. Integrating CPRs into guidelines and practice software might increase familiarity and use.

Acute Deep Vein Thrombosis Treated with Porcine Plasmin

1974 ◽  
Vol 32 (02/03) ◽  
pp. 468-482 ◽  
Author(s):  
O Storm ◽  
P Ollendorff ◽  
E Drewsen ◽  
P Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Initial Dose ◽  
Treated Group ◽  
Allergic Reactions ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Thrombolytic Effect ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

SummaryThe thrombolytic effect of pig plasmin was tested in a double blind trial on patients with deep venous thrombosis in the lower limb. Only patients with not more than three days old thrombi were selected for this study. The diagnosis of deep vein thrombosis was made clinically and confirmed by phlebography. Lysofibrin Novo (porcine plasmin) or placebo (porcine plasminogen) was administered intravenously to the patients. The enzyme and the placebo were delivered as lyophilized powder in labelled bottles - the contents of the bottles were unknown to the doctor in charge of the clinical administration of the trial. An initial dose of plasmin/plasminogen of 30 unit per kg body weight given slowly intravenously (1-1% hours infusion) was followed by a maintenance dosis of 15 per cent the initial dose per hour for the following 5-7 hours. In most cases a similar maintenance dosis was given the next day. In all patients heparin was administered after ending the plasmin/plasminogen infusion. The results of the treatment was evaluated clinically as well as by control phlebo- grams the following days.A statistically significant improvement was found in the plasmin treated group compared with the placebo (plasminogen) treated group. Thrombolysis was obtained clinically and phlebographically in 65 per cent of the plasmin treated group, but only in 15 per cent of the control patients were improvements found.This study has thus demonstrated that plasmin treatment according to a standard scheme was able to induce thrombolysis. There were only a few and insignificant side effects. Allergic reactions have not been seen and only very simple tests are required.

Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting

The Lancet ◽  
2006 ◽  
Vol 367 (9516) ◽  
pp. 1075-1079 ◽  
Author(s):  
Liam Smeeth ◽  
Claire Cook ◽  
Sara Thomas ◽  
Andrew J Hall ◽  
Richard Hubbard ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Acute Infection ◽  
Community Setting ◽  
Vein Thrombosis ◽  
Deep Vein
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