PURPOSE: To report the efficacy of catheter-directed thrombolysis with a combination of a thrombolytic agent (reteplase) and a glycoprotein (GP) IIb/IIIa platelet receptor antagonist (abciximab) in peripheral @entity432 . MATERIALS AND METHODS: Fifteen @entity1 with lower extremity arterial @entity715 (age range, 40-96 y; mean, 73 y) were prospectively enrolled in a protocol approved by the Institutional Review Committee. Nine @entity1 had native @entity432 , three (33%) of whom had subacute symptoms (>14 d) and one of whom had chronic symptoms (>3 mo). Four @entity1 had acute arterial graft @entity715 . Two @entity1 with lower extremity bypass grafts presented with subacute @entity63 . All @entity1 received catheter-directed infusion of reteplase (0.5 U/h) in combination with intravenous administration of abciximab (0.25-mg/kg bolus followed by 0.125 microg/kg/min infusion) for 12 hours without systemic heparinization. The thrombolytic success was studied by Doppler ultrasonography (US) and angiography. RESULTS: Complete thrombolysis and clinical success was achieved in 14 of the 15 @entity1 (93%). One @entity1 with unsuccessful thrombolysis underwent major amputation. The mean thrombolysis time per Doppler US procedure was 6.8 hours (range, 2-30 h). Angiographic patency was achieved at a mean of 17.5 hours (range, 4-36 h) corresponding to a mean dose of reteplase of 8.8 U. The mean increase in ankle-brachial index was 0.52 (range, 0-0.9). No major @entity548 occurred. The 30-day primary patency rate was 93%. CONCLUSION: The combination of reteplase and abciximab in catheter-directed arterial thrombolysis is feasible and effective. This combination therapy pilot study suggests short thrombolysis times and minimal adverse effects in catheter-directed thrombolytic therapy for peripheral @entity432 .

Initial experience with the combination of reteplase and abciximab for thrombolytic therapy in peripheral XXXX : a pilot study.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhagic complications'] @entity63 :: ('MESH:D007511', 'Disease') :: ['limb ischemia'] @entity432 :: ('MESH:D001157', 'Disease') :: ['arterial occlusions', 'arterial occlusive disease'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thromboses']
@entity432 :: (MESH:D001157,Disease) :: ['arterial occlusive disease']
