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1.
Genet Mol Res ; 13(3): 6107-12, 2014 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-25117369

RESUMO

The aim of this study was to evaluate and investigate the pathogenetic mechanism and countermeasures of subacute thrombosis (SAT) after coronary stenting in elderly diabetic patients. The clinical characteristics and pathogenetic mechanisms in 3 cases of SAT after stent implantations in elderly diabetic patients were retrospectively examined to determine the treatment strategies for SAT. Among 98 patients with diabetes who had coronary stents implanted or were >60 years of age, three (3.06%) had SAT. One case of SAT was diagnosed by angiography; coronary balloon dilatation, thrombolysis, and re-perfusion resulted in full recovery in this case. The second case involved potential SAT, and in the third case, SAT was not ruled out. Two cases were characteristic of ST-segment elevation myocardial infarction, and one case, in which SAT was not ruled out, resulted in sudden death. SAT within a stent may be related to intraoperative stent malapposition caused by a grade C lesion, age, diabetes, chronic total occlusion, or postoperative irregular administration of medication.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Trombose Coronária/etiologia , Trombose Coronária/terapia , Stents/efeitos adversos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença das Coronárias/complicações , Doença das Coronárias/diagnóstico , Doença das Coronárias/terapia , Diabetes Mellitus Tipo 2/complicações , Evolução Fatal , Feminino , Fibrinolíticos/administração & dosagem , Fibrinolíticos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico
2.
Clin Transl Oncol ; 9(3): 198-200, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17403633
6.
Rev Neurol (Paris) ; 153(4): 271-4, 1997 May.
Artigo em Francês | MEDLINE | ID: mdl-9296147

RESUMO

A 37 year-old man had headaches for 10 days, then a single tonic-clonic seizure and coma due to an extensive cerebral venous thrombosis. In spite of full-dose heparin treatment for 7 days, the clinical picture worsened along with increasing edema on CT-Scan. Direct thrombolytic treatment was then performed using transvenous catheterization and instillation of Urokinase (2.6 MU over 4 days). A near complete repermeabilization of the sinuses was obtained and the patient improved dramatically in a few days. The only adverse effect of Urokinase was hematuria. Based on our experience and review of the literature which includes 26 previous cases, direct thrombolytic therapy appears to be a relatively safe procedure. This treatment should be considered in a patient with extensive dural sinus thrombosis which fails to respond to heparin treatment.


Assuntos
Embolia e Trombose Intracraniana/tratamento farmacológico , Ativadores de Plasminogênio/administração & dosagem , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Adulto , Cateterismo Periférico , Resistência a Medicamentos , Heparina , Humanos , Injeções , Masculino , Terapia Trombolítica
12.
J Vasc Interv Radiol ; 5(5): 705-13, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-8000119

RESUMO

PURPOSE: A preliminary evaluation of the efficacy and safety of treating patients with acute stroke with intraarterial urokinase infusions was performed. PATIENTS AND METHODS: Twelve patients with acute stroke were treated within 8 hours of symptom onset (average, 5 hours). Thrombolysis was performed within the middle cerebral (n = 10), internal carotid (n = 1), and basilar (n = 1) arteries. Urokinase (160,000-500,000 IU) was infused through microcatheters placed into or adjacent to the thrombi. RESULTS: Thrombolysis was angiographically successful in nine patients (75%), all of whom had long-term neurologic improvement. No or minimal neurologic deficits were present in six patients (50%). Thrombolysis failed in three patients (25%); one patient died and two developed severe permanent neurologic deficits. No hemorrhagic complications occurred. CONCLUSION: Preliminary results suggest that intraarterial urokinase infusion may be effective and safe for treating patients with acute stroke. Potentially devastating neurologic damage was averted or lessened in nine patients (75%). No additional neurologic damage was caused by intervention in the remaining three patients (25%).


Assuntos
Transtornos Cerebrovasculares/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico , Angiografia Cerebral , Artérias Cerebrais , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/prevenção & controle , Fatores de Tempo , Resultado do Tratamento , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem
13.
AJNR Am J Neuroradiol ; 15(3): 487-92, 1994 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8197945

RESUMO

PURPOSE: To determine the incidence, appearance, and clinical significance of lesions mimicking intraparenchymal hemorrhages on CT in patients treated with intracranial intraarterial thrombolysis for acute strokes. METHODS: Ten cases of acute stroke treated with direct intraarterial urokinase infusion were retrospectively reviewed. Clinical and radiographic findings before and after therapy were all evaluated. RESULTS: Six (60%) of the 10 patients showed areas of increased attenuation on CT shortly after thrombolytic therapy. The lesions were associated with clinical deterioration in two cases (20%); in these two cases the lesions persisted on CT for several days. The lesions were asymptomatic in two (20%) cases; the lesions cleared on CT within 24 hours in those two patients. In two (20%) patients, immediate clinical improvement was evident despite the radiodense areas. These lesions also cleared within 24 hours. CT Hounsfield unit measurements of four of the lesions revealed very high Hounsfield units in two lesions, only one of which was a symptomatic lesion. MR in two cases revealed residue of hemorrhage. CONCLUSION: Intraparenchymal areas of increased attenuation may be seen on the CT scans of patients after intraarterial thrombolysis. The density is often at least partially attributable to contrast extravasation. The lesions should not necessarily be interpreted as hemorrhage alone, especially in the absence of clinical deterioration. Rapid clearing may be a positive prognostic sign.


Assuntos
Hemorragia Cerebral/diagnóstico por imagem , Transtornos Cerebrovasculares/tratamento farmacológico , Terapia Trombolítica , Tomografia Computadorizada por Raios X , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Doença Aguda , Adulto , Idoso , Encéfalo/irrigação sanguínea , Hemorragia Cerebral/etiologia , Transtornos Cerebrovasculares/diagnóstico por imagem , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Terapia Trombolítica/efeitos adversos , Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico
14.
Cienc. méd. (San Miguel de Tucumán) ; 8(6): 335-51, nov.-dic. 1993. tab
Artigo em Espanhol | LILACS | ID: lil-175498

RESUMO

La trombosis venosa profunda aguda puede presentar dos secuelas graves: la embolia pulmonar en la primera etapa y el síndrome postrombótico como complicación tardía. Es por lo tanto comprensible que la primera preocupación sea la implementación de una terapia activa como la trombolisis. Es necesario reabrir la oclusión en pocos días. Ello es posible sólo mediante la adición de factores exógenos tales como la Estreptoquinasa, la Uroquinasa y el TPA. Dosis altas de heparina se usan para reducir notoriamente la incidencia de embolia pulmonar. El tratamiento de mantenimiento se realiza con anticoagulantes orales como los cumarínicos y la Warfarina.


Assuntos
Extremidades/patologia , Farmacologia , Embolia Pulmonar/complicações , Tromboflebite/complicações , Tromboflebite/epidemiologia , Tromboflebite/terapia , Fibrinolíticos/uso terapêutico , Anticoagulantes/uso terapêutico , Fibrinolisina/administração & dosagem , Heparina/administração & dosagem , Heparina/efeitos adversos , Heparina/farmacologia , Heparina/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Estreptoquinase/administração & dosagem , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Varfarina/uso terapêutico
15.
Cienc. méd. [San Miguel de Tucumán] ; 8(6): 335-51, nov.-dic. 1993. tab
Artigo em Espanhol | BINACIS | ID: bin-21967

RESUMO

La trombosis venosa profunda aguda puede presentar dos secuelas graves: la embolia pulmonar en la primera etapa y el síndrome postrombótico como complicación tardía. Es por lo tanto comprensible que la primera preocupación sea la implementación de una terapia activa como la trombolisis. Es necesario reabrir la oclusión en pocos días. Ello es posible sólo mediante la adición de factores exógenos tales como la Estreptoquinasa, la Uroquinasa y el TPA. Dosis altas de heparina se usan para reducir notoriamente la incidencia de embolia pulmonar. El tratamiento de mantenimiento se realiza con anticoagulantes orales como los cumarínicos y la Warfarina. (AU)


Assuntos
Tromboflebite/complicações , Tromboflebite/terapia , Tromboflebite/epidemiologia , Extremidades/patologia , Farmacologia , Embolia Pulmonar/complicações , Anticoagulantes/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Fibrinolíticos/uso terapêutico , Heparina/uso terapêutico , Heparina/farmacologia , Heparina/administração & dosagem , Heparina/efeitos adversos , Estreptoquinase/administração & dosagem , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Fibrinolisina/administração & dosagem , Varfarina/uso terapêutico
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