[Intra-arterial thrombolytic therapy of ischaemic complications of lower-limb diabetic angiopathy]

Angiol Sosud Khir. 2012;18(3):13-7.
[Article in Russian]

Abstract

Based on the parameters of haemostasis, free radical oxidation and endogenous intoxication the study was aimed at assessing efficacy of intra-arterial administration of urokinase medac in complicated forms of lower-limb diabetic angiopathy. The authors assessed the outcomes of treating a total of 32 patients with complicated forms of lower-limb diabetic angiopathy on the background of basic therapy and 30 patients whose combined therapy included intra-arterial administration of the thrombolytic agent urokinase medac, also studying the indices of haemostasis, endogenous intoxication, free-radical oxidation and antioxidant defence. At admission to hospital, patients were found to have shifts of the coagulogram towards hypercoagulation. The group of patients receiving intra-arterial administration of urokinase showed that the examined parameters on day 20 of treatment as compared with basic therapy alone increased: those of coagulability by 6% (p<0.05), activated partial thromboplastin time by 14% (p<0.01), thrombin time by 9.2% (p<0.01), antithrombin III by 7% (p<0.001). The fibrinogen level decreased by 9% (p<0.05), malonic dialdehyde concentration dropped by 30% (p<0.001), the concentrations of catalase and superoxide dismutase elevated by 55% (p<0.001) and 42%, respectively (p<0.05). The effective concentration of albumin by day 20 increased up to 42.03±0.36 g/L and was by 5% higher as compared with the basic therapy alone (p<0.005). The toxicity index fell to 0.04+0.1 which was by 50% less than after basic therapy. Conclusion. Intra-arterial administration of urokinase medac in treatment of lower-limb diabetic angiopathy considerably normalizes elevated processes of coagulation, accompanied by decreased intensity of free-radical oxidation and followed by elevated concentration of the antioxidant protection enzymes and a decrease in the degree of endogenous intoxication.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / complications*
  • Diabetic Angiopathies / drug therapy
  • Dose-Response Relationship, Drug
  • Femoral Artery
  • Follow-Up Studies
  • Hemostasis / drug effects*
  • Humans
  • Injections, Intra-Arterial
  • Ischemia / blood
  • Ischemia / drug therapy*
  • Ischemia / etiology
  • Lower Extremity / blood supply*
  • Thrombolytic Therapy / methods*
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage*

Substances

  • Urokinase-Type Plasminogen Activator