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Locally Applied Recombinant Plasmin Results in Effective Thrombolysis in a Porcine Model of Arteriovenous Graft Thrombosis

Title: Locally Applied Recombinant Plasmin Results in Effective Thrombolysis in a Porcine Model of Arteriovenous Graft Thrombosis
Authors: Hoefer, IE; Stroes, ESG; Pasterkamp, G; Levi, MM; Reekers, JA; Verhagen, Hence; Meijers, JC; Humphries, JE; Rotmans, JI
Source: Hoefer, IE, Stroes, ESG, Pasterkamp, G, Levi, MM, Reekers, JA, Verhagen, H, Meijers, JC, Humphries, JE & Rotmans, JI 2009, 'Locally Applied Recombinant Plasmin Results in Effective Thrombolysis in a Porcine Model of Arteriovenous Graft Thrombosis', Journal of Vascular and Interventional Radiology, vol. 20, no. 7, pp. 951-958. https://doi.org/10.1016/j.jvir.2009.03.043
Publication Year: 2009
Subject Terms: /dk/atira/pure/keywords/researchprograms/AFL001000/EMCCOEUR09; name=EMC COEUR-09
Description: PURPOSE: Arteriovenous (AV) graft thrombosis is a frequent complication in patients undergoing hemodialysis. Thrombolytic therapy with tissue plasminogen activator (TPA) is hampered by the risk of bleeding complications. Locally delivered plasmin may have similar thrombolytic efficacy with a superior safety profile, so herein it was compared with TPA in a porcine model of AV graft thrombosis. MATERIALS AND METHODS: AV grafts were created bilaterally between the carotid artery and jugular vein. Graft thrombosis was induced by clamping the grafts for 1 hour. On day 3, one graft was treated with a 2-mL local recombinant plasmin injection (10 mg; n = 10) with the contralateral graft being infused with TPA (10 mg, n = 8) or saline solution (n = 2). Thrombolytic efficacy was assessed by weighing the residual clot and released clot fragments. RESULTS: After saline solution injection, the mean residual clot weight in the graft was 618 mg. Local administration of TPA showed the least residual clot in the graft (69 mg +/- 26), with large clot particles reaching the venous outflow (241 mg 23). Plasmin treatment significantly reduced the released clot mass versus TPA (52 mg +/- 23; P < .05), whereas residual clot weight was greater compared with TPA treatment (140 mg +/- 22; P < .05). Overall thrombolytic activity of plasmin (ie, residual clot plus released clot) was significantly better than that of TPA (193 mg +/- 25 vs 310 +/- mg 35; P < .05). CONCLUSIONS: The thrombolytic efficacy of recombinant plasmin was shown to be superior to that of TPA in this study.
Document Type: article in journal/newspaper
Language: unknown
ISSN: 1051-0443; 1535-7732
Relation: info:eu-repo/semantics/altIdentifier/pmid/19481472; info:eu-repo/semantics/altIdentifier/pissn/1051-0443; info:eu-repo/semantics/altIdentifier/eissn/1535-7732
DOI: 10.1016/j.jvir.2009.03.043
Availability: https://pure.eur.nl/en/publications/214a0ae8-d6fa-4e2b-9c7f-7e7153a21a43; https://doi.org/10.1016/j.jvir.2009.03.043; https://hdl.handle.net/1765/57251
Rights: info:eu-repo/semantics/restrictedAccess
Accession Number: edsbas.55391F9
Database: BASE