PURPOSE: To explore the potential benefits from heating recombinant tissue plasminogen activator (rtPA) before catheter-directed thrombolysis in @entity1 with @entity63 of <30 days' duration. METHODS: Over a 2-year period, 34 @entity1 (26 @entity1 ; mean age 63.5 years, range 39-80) with 10 iliac and 24 infrainguinal @entity432 (5 embolic and 29 @entity715 ) were treated with two 5-mg boluses of rtPA injected into the proximal clot, followed by 2 additional 5-mg boluses of rtPA. In the first 18 @entity1 (group A), room temperature rtPA was administered, whereas in the last 16 @entity1 (group B), the rtPA boluses were heated to 38 degrees C for 30 minutes before injection. Residual @entity715 was treated with a continuous infusion of 2.5 mg/h of rtPA for 4 hours then at a reduced dose (1 mg/h). RESULTS: Successful thrombolysis was achieved in 28 (82%) arteries. Unmasked lesions were treated with balloon angioplasty/stenting in 17 cases and with surgery in 4. One @entity1410 occurred in group A. Heating the rtPA did not significantly alter the outcome of thrombolysis. However, a statistically significant reduction in the total rtPA dose was observed in group B (24.28 mg versus 27.9 mg in group A, p=0.05), as well as quicker lysis (2 hours, 42 minutes versus 6 hours, 12 minutes in group A, p=0.001). There was no statistical difference in the amputation-free survival at 30 days between the groups. CONCLUSIONS: In @entity1 with acute or subacute @entity63 treated with catheter-directed thrombolysis, heating the rtPA results in faster lysis with a considerable reduction in the total dose of the lytic agent.

Potential benefits from heating the high-dose rtPA boluses used in catheter-directed thrombolysis for acute/subacute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'men'] @entity63 :: ('MESH:D007511', 'Disease') :: ['lower limb ischemia', 'lower-limb ischemia'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['fatal retroperitoneal hematoma'] @entity432 :: ('MESH:D001157', 'Disease') :: ['arterial occlusions'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus', 'thrombotic']
@entity63 :: (MESH:D007511,Disease) :: ['lower limb ischemia']
