Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis

Journal Article · Mon Feb 15 00:00:00 EST 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9777-2· OSTI ID:21429050

Liping, Guo; Hanying, Lin; Fengyong, Liu; Feng, Duan; Zhijun, Wang ^[1]

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1. Chinese PLA General Hospital, Department of Interventional Radiology (China)

The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 {+-} 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 {+-} 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 {+-} 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.

• OSTI ID: 21429050
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 33, Issue 1; Conference: BSIR (British Society of Interventional Radiology) 2009 annual meeting, Brighton (United Kingdom), 4-6 Nov 2009; Other Information: DOI: 10.1007/s00270-009-9777-2; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
COMPUTERIZED TOMOGRAPHY
INFUSION
THERAPY
THROMBOSIS
TUBES
UROKINASE
VEINS
BLOOD COAGULATION FACTORS
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ENZYMES
FIBRINOLYTIC AGENTS
HEMATOLOGIC AGENTS
HYDROLASES
INTAKE
MEDICINE
NONSPECIFIC PEPTIDASES
ORGANIC COMPOUNDS
ORGANS
PEPTIDE HYDROLASES
PROTEINS
TOMOGRAPHY
VASCULAR DISEASES