The Experimental Study On The Utility Of Catheter-directed Thrombolysis Therapy For The Acute Central Lower Extremity Deep Vein Thrombosis

Objective To treat the acute central lower extremity deep vein thrombosis with the urokinase by the catheter-directed thrombolysis.To study whether the dosage and administration of the urokinase and the position of the catheter will affect the effect of thrombolysis or not. To offer the experiment basis of making a safe and effective clinical therapeutic schedule.Method The iliofemoral vein thrombosis of the dog was formed by occluding the blood flow and injecting the thrombin. The molds were randomly divided into 5 groups,and there were 6 molds each group.Group A were treated by continuous thrombolysis with the low-dose urokinase through the catheter into the distal part of the thrombosis.Group B were treated by the continuous thrombolysis with low-dose urokinase through the catheter into the distal part of the thrombosis after a high-dose being poured in a short time.Group C were treated by uncontinuous thrombolysis with the medium-dose urokinase through the catheter into the distal part of the thrombosis.Group D were treated by continuous thrombolysis with the low-dose urokinase through the catheter into the proximal part of the thrombosis after a high-dose being poured in a short time.There was no therapy put on group E.The venography was taken to know the effect of thrombolysis.The period for recanalization,the dosage of urokinase used,complications and APTT were recorded.Result There were 30 molds of the iliofemoral vein thrombosis successfully established.And the success rate was 100%. Group A,Group B and Group C were compared with the same position of the catheter but different dosage and administration of the urokinase.As for the period for recanalization, Group B was shortest(150 minutes),followed by Group C(185 minutes),and Group A (210 minutes).There were statistical differences between Group A,Group B and Group C (P<0.01). Group B and Group D were compared with the same dosage and administration of the urokinase but different position of the catheter.The period for recanalization of Group B(150 minutes) was shorter than Group D(300 minutes).In Group C ,the incidence of hemorrhage complication was highest,and the variety of APTT was most significant,and the dosage was also the highest.There were no autolysis happened in 5 hours in Group E.Conclusions 1.The dosage and administration of the urokinase can affect the effect of thrombolysis.The continuous thrombolysis with low-dose urokinase through the catheter into the thrombosis after a high-dose being poured in a short time is the most effective way. 2. The position of the catheter can also affect the effect of thrombolysis. Placing the catheter in the distal part of the thrombosis is more effective than that in the proximal part.