Key result
Retrograde coronary venous administration of rt-PA significantly reduced the time to thrombolysis compared to systemic intravenous administration (13.4 vs 27.8 minutes; p<0.001).
Absolute Event Rate: 13.4% vs 27.8%
p-value: p=<0.001
Experimental study reveals faster clot lysis and superior functional recovery with coronary venous retroinfusion of rt-PA in canine models, suggesting an effective route for myocardial salvage.
Recent studies of interventional therapy by way of the coronary venous system have demonstrated that it can protect acutely ischemic myocardium. To evaluate the efficacy of coronary venous retroinfusion compared with systemic intravenous administration of recombinant tissue-type plasminogen activator (rt-PA), 14 dogs were studied with a copper coil-induced thrombus in the left anterior descending coronary artery. The rt-PA (24,000 fluorescence units/kg) was administered continuously, either intravenously (n = 8) or retrogradely (n = 6), for 30 min beginning 60 min after coronary occlusion. Thrombolysis was determined by repetitive coronary angiography. All dogs were killed 3 h after termination of rt-PA infusion and infarct size was measured by the triphenyltetrazolium chloride staining technique. Complete thrombolysis occurred in five of the six dogs in the retroinfusion group and four of the eight dogs in the systemic intravenous infusion group. Partial lysis was achieved in two dogs treated by intravenous infusion. Lysis did not occur in one dog treated with retroinfusion and in two dogs treated with intravenous infusion. Time to thrombolysis was 13.4 +/- 2.3 min in the retroinfusion group versus 27.8 +/- 4.8 min in the intravenous group (p less than 0.001). Myocardial functional recovery in the ischemic zone measured by two-dimensional echocardiography 60 min after reperfusion was significant only in the retroinfusion group (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Miyazaki et al. (1991) studied Copper coil-induced thrombus in the left anterior descending coronary artery (n=14). Retrograde coronary venous administration of recombinant tissue-type plasminogen activator (rt-PA) vs. Systemic intravenous administration of rt-PA was evaluated on Time to thrombolysis (p=<0.001). Retrograde coronary venous administration of rt-PA significantly reduced the time to thrombolysis compared to systemic intravenous administration (13.4 vs 27.8 minutes; p<0.001).
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