Admixture of heparin with urokinase to decrease thrombolysis time and urokinase dose in polytetrafluoroethylene dialysis graft recanalization.

Abstract

PURPOSE: To determine whether the addition of heparin to urokinase during dialysis graft thrombolysis can lower urokinase dose and shorten procedure time. PATIENTS AND METHODS: Patients who underwent dialysis graft thrombolysis during an 18-month period were studied retrospectively. Twenty patients were treated with urokinase alone, and 19 patients were treated with urokinase and heparin. Thrombolysis was performed in the angiography suite by using a crossed-catheter technique. Urokinase was administered directly into the thrombus. In patients receiving heparin, 5,000 IU was added directly to the initial urokinase solution. RESULTS: In patients who received urokinase alone, an average of 750,000 U of urokinase was used, and the average procedure time was 2 hours 42 minutes. When heparin was added, an average of 435,000 U of urokinase was used, and the average procedure time was 2 hours. CONCLUSION: The addition of heparin to urokinase can decrease both urokinase dose and thrombolysis time in the recanalization of dialysis grafts.