Biomaterial Database

Pharmacomechanical thrombolysis with urokinase for treatment of thrombosed hemodialysis access grafts. A comparison with surgical thrombectomy. 1994

J J Sands, and S Patel, and D J Plaviak, and C L Miranda

Renal Consultants of Wyoming Valley, Wilkes Barre, PA 18702-2699, USA.

Seventy-one consecutively occluded polytetrafluoroethylene (PTFE) grafts treated with pharmacomechanical thrombolysis were compared with 75 surgical controls. The patients undergoing thrombomechanical lysis had a comparable rate of successful declotting (91% vs. 90.7%) and no significant difference in patency at 24 and 48 hr, 1 week, and 1 and 6 months. Patients undergoing thrombolysis required less overnight hospitalization (17 vs. 82%) (P < 0.001) and their hospital stays averaged 1.03 days versus 3.43 days in the surgical thrombectomy group (P < 0.0001). Complication rates were similar in both groups. Hospital charges and physician fees were significantly lower in the thrombolysis group, with total charges averaging $6,802 versus $12,740 (P = 0.0018). These cost differences were maintained even when patients with extended stays were excluded. In conclusion, pharmacomechanical thrombolysis provides efficacy and complications comparable to surgical thrombectomy, with the benefits of a decreased rate of hospitalization, decreased total number of days of hospitalization, and significant cost savings. The authors determined that pharmacomechanical thrombolysis is the preferable first intervention for acutely occluded PTFE grafts.

UI	MeSH Term	Description	Entries
D007902	Length of Stay	The period of confinement of a patient to a hospital or other health facility.	Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D011138	Polytetrafluoroethylene	Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron.	FEP,Fluon,Politef,Polytef,TFE,Teflon,Expanded PTFE,Fluoroplast,GORE-TEX,Goretex,PTFE,Tarflen,GORE TEX,PTFE, Expanded
D001807	Blood Vessel Prosthesis	Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.	Vascular Prosthesis,Blood Vessel Prostheses,Tissue-Engineered Vascular Graft,Graft, Tissue-Engineered Vascular,Grafts, Tissue-Engineered Vascular,Prostheses, Blood Vessel,Prostheses, Vascular,Prosthesis, Blood Vessel,Prosthesis, Vascular,Tissue Engineered Vascular Graft,Tissue-Engineered Vascular Grafts,Vascular Graft, Tissue-Engineered,Vascular Grafts, Tissue-Engineered,Vascular Prostheses,Vessel Prostheses, Blood,Vessel Prosthesis, Blood
D002408	Catheters, Indwelling	Catheters designed to be left within an organ or passage for an extended period of time.	Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D003365	Costs and Cost Analysis	Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.	Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D006435	Renal Dialysis	Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.	Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006760	Hospitalization	The confinement of a patient in a hospital.	Hospitalizations
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013927	Thrombosis	Formation and development of a thrombus or blood clot in BLOOD VESSELS.	Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses
D014568	Urokinase-Type Plasminogen Activator	A proteolytic enzyme that converts PLASMINOGEN to FIBRINOLYSIN where the preferential cleavage is between ARGININE and VALINE. It was isolated originally from human URINE, but is found in most tissues of most VERTEBRATES.	Plasminogen Activator, Urokinase-Type,U-Plasminogen Activator,Urinary Plasminogen Activator,Urokinase,Abbokinase,Kidney Plasminogen Activator,Renokinase,Single-Chain Urokinase-Type Plasminogen Activator,U-PA,Single Chain Urokinase Type Plasminogen Activator,U Plasminogen Activator,Urokinase Type Plasminogen Activator