Ultrarapid Urokinase in Hemodialysis Access Occlusion

Michael C. Brunner*, Terence A.S. Matalon, Suresh K. Patel, Virginia McDonald, Stephen C. Jensik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Over a 3-month period, 14 consecutive hemodialysis access occlusions were treated with 1–1.25 million IU of urokinase (UK) delivered at a rate of 20,000 IU/min. After systemic heparin administration, lytic infusion via the crossed-catheter technique was performed with use of pediatric microdrip pumps, with determination of success within 1 hour. Patency was established radiographically in 11 of 14 occlusions, for a 79% immediate success rate. At 285-day mean follow-up, 9% (one of 11) remained patent without further radiologic or surgical intervention; graft survival was 64% (seven of 11). No significant complications occurred with use of ultrarapid UK. The 1-hour outpatient procedure safely allowed for rapid triage between surgical and radiologic intervention, minimal catheter manipulation or physician dependency, shorter duration compression of any bleeding venipuncture sites during UK administration, and greater patient comfort because of shortened procedure times.

Original languageEnglish (US)
Pages (from-to)503-506
Number of pages4
JournalJournal of Vascular and Interventional Radiology
Volume2
Issue number4
DOIs
StatePublished - 1991

Keywords

  • ACT
  • Dialysis, shunts, 91.494
  • Fistula, arteriovenous, 91.494
  • PTA
  • UK
  • Urokinase
  • activated clotting time
  • percutaneous transluminal angioplasty
  • urokinase

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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