Thrombolytic and Antiplatelet Therapy in Peripheral Vascular Disease with Use of Reteplase and/or Abciximab: The SCVIR Consultants' Conference; May 22, 2000; Orlando, FL

Abstract

THROMBOLYTIC therapy with catheter-directed urokinase (UK) was, for more than 15 years, an essential part of the management of acute arterial and venous occlusive peripheral vascular disease (PVD). Thrombolytic therapy also has been an integral part of the management of dialysis intravenous access devices. Since the suspension of sales of UK in the United States in 1998, the search for alternative agents has focused on the newer second- and third-generation plasminogen activators, an important drug class that first became available for the treatment of acute myocardial infarction (MI). Two of these plasminogen activators, reteplase and alteplase, although not approved for use in PVD, have been adopted widely by interventionalists as efficacious agents in the resolution of peripheral thrombi and/or emboli and the subsequent restoration of vessel patency. A core series of case experiences with reteplase in the peripheral setting are now available in the literature ( 1 Davidian MM Powell A Benenati JF et al. Initial results of reteplase in the treatment of acute lower extremity arterial occlusions. J Vasc Interv Radiol. 2000; 11: 289-294 Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar , 2 Laird JR Dangas G Jaff M et al. Intra-arterial reteplase for the treatment of acute limb ischemia. J Invas Cardiol. 1999; 11: 757-762 PubMed Google Scholar , 3 Ouriel K Katzen B Mewissen M et al. Reteplase in the treatment of peripheral arterial and venous occlusions: a pilot study. J Vasc Interv Radiol. 2000; 11: 849-854 Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar ).