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Abstract
Tissue type plasminogen activator (t-PA) is an effective thrombolytic agent in experimental
animals and in humans. We have previously observed that the thrombolytic effect of
t-PA persists beyond its time of clearance from the circulation and that wound bleeding
induced by a high dose infusion of t-PA is delayed for at least one and a half hours
after commencing the infusion. These observations suggest that improved thrombolysis
may be obtained with t-PA by infusing a high dose over a short period of time. To
test this hypothesis we compared the thrombolytic and hemorrhagic effects of t-PA
infused over 240, 60, 30 and 15 minutes in the rabbit.
A 4 hour infusion of 30, 000 U/kg of t-PA produced 36% thrombolysis. The same dose
of t-PA infused over 60, 30 and 15 minutes produced 87%, 88% and 96% thrombolysis,
respectively (p<0.01). The 1 hour infusion of 30, 000 U/kg of t-PA produced a significant
increase in blood loss relative to saline infusion (p<0.01). The same dose infused
over 30 and 15 minutes did not produce significantly more bleeding than saline. A
higher dose of t-PA, 60, 000 U/kg, infused over 4 hours, produced 95% thrombolysis,
but was associated with a significant increase of blood loss (p<0.001).
Our findings suggest that improved thrombolysis with t-PA with minimal bleeding side-effects
is achieved in rabbits when t-PA is administered in a relatively high dose given over
a short period of time.
Keywords
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Article info
Publication history
Accepted:
September 8,
1985
Received:
June 5,
1985
Identification
Copyright
© 1985 Published by Elsevier Inc.