ABSTRACT
From 1989 to September 1997 1184 patients with deep vein thrombosis were treated. 606 (51.2%) received a specific therapy with loco-regional lysis. The application of two cycles of 20 mg Alteplase within 8 hours prevailed in combination with 1000 IE heparin per hour. In absence or lack of therapeutical effect further cycles of 20 or 40 mg of Alteplase were given. In the time free from lysis the patients received 30,000 IE heparin/24 hours depending on the individual aPTT (1.5-2.5 times prolonged). We developed a special drainage-management using perforans-veins during the loco-regional lysis. Complete lysis resulted in nearly half of the cases and in another third there was a lysis of more than 50%. Complications were observed in 5.8% of the patients, 4% due to heparinization. Importantly no life-threatening bleeding like gastrointestinal or cerebral bleeding or pulmonary embolism occurred. According to our data we conclude that the loco-regional lytic effect tends to be better than using systemical lysis, the risks are minimized and patient monitoring and treatment is much simpler.
Subject(s)
Drainage/methods , Heparin/administration & dosage , Postoperative Complications/drug therapy , Thrombolytic Therapy/methods , Thrombophlebitis/drug therapy , Tissue Plasminogen Activator/administration & dosage , Aged , Aged, 80 and over , Bandages , Combined Modality Therapy , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Male , Middle AgedABSTRACT
In a double-blind, randomised multicentre study buflomedil, a vasoactive substance, was compared with placebo in the treatment of 93 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either buflomedil (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the differences in the improvement between the two groups were highly significant and in favour of buflomedil: for the pain-free walking distance p less than 0.001 and for the total walking distance p less than 0.01. The results indicate that buflomedil has a beneficial effect on the symptoms and lengthens the walking distance in patients with arterial occlusive disease.
