March 1, 1995British journal of surgery
Immediate and early follow-up results of pulse spray thrombolysis in patients with peripheral ischaemia
Key result
Pulse spray thrombolysis is linked to a ~12-fold reduction in lysis time versus conventional infusion.
- 12-fold reduction
- P<0.001
- n=158
Why the study?
Pulse spray thrombolysis is an accelerated peripheral thrombolysis technique evaluated for rapid restoration of patency and limb salvage in patients with peripheral ischaemia.
Does pulse spray thrombolysis using rtPA improve lysis time and limb salvage in patients with peripheral ischaemia compared to conventional low-dose infusion thrombolysis?
Comparison
Pulse spray thrombolysis vs conventional low-dose infusion thrombolysis using rtPA
Design
Cohort study
Follow-up
18 months
Authors
Discussion
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Member takes
Implication
Associated with shorter lysis times in peripheral ischaemia; hypothesis-generating, requiring randomized trials before practice change.
Study Design
Type
Cohort (n=158)
Structured PICO
Does pulse spray thrombolysis using rtPA improve lysis time and limb salvage in patients with peripheral ischaemia compared to conventional low-dose infusion thrombolysis?
P
Population
158 patients with peripheral ischaemia, including 38 treated with pulse spray thrombolysis and 120 historical controls treated with conventional infusion, followed for up to 18 months.
E
Exposure
Pulse spray thrombolysis using recombinant tissue plasminogen activator (rtPA) injected manually via a pulse spray catheter (0.33 mg/ml, bolus 0.2 ml, median total dose 18 mg).
C
Comparator
120 consecutive patients previously treated with conventional low-dose infusion thrombolysis using rtPA.
O
Outcome
Lysis time, restoration of patency and flow, clinical success at 30 days, and cumulative limb salvage and patency rates at 18 months follow-up.hard clinical
Main Result
Effect estimate: 12-fold reduction
Absolute Event Rate: 120% vs 1545%
p-value: p=<0.001
Pulse spray thrombolysis significantly reduces lysis time compared to conventional infusion and achieves high rates of limb salvage and patency in patients with peripheral ischaemia.
Cite This Study
Yusuf et al. (1995) conducted a cohort in Peripheral ischaemia (n=158). Pulse spray thrombolysis using recombinant tissue plasminogen activator (rtPA) vs. Conventional low-dose infusion thrombolysis using rtPA was evaluated on Median lysis time (minutes) (12-fold reduction, p=<0.001). Pulse spray thrombolysis significantly reduced median lysis time compared to conventional low-dose infusion (120 vs 1545 minutes; P<0.001) in patients with peripheral ischaemia.