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- Hager, Jakob, 1967-, et al.
(author)
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HIV/aids ger ny kärlsjukdomsentitet
- 2005
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 102, s. 36-37
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Journal article (other academic/artistic)
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- Plate, G., et al.
(author)
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Thrombolysis for acute lower limb ischaemia - a prospective, randomised, multicentre study comparing two strategies
- 2006
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 31, s. 651-660
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Journal article (peer-reviewed)abstract
- Objectives To test if initial high-dose, pulse-spray thrombolysis improves the early and late outcome of lower limb ischaemia as compared with low-dose infusion alone. Design Prospective randomised multicentre study. Material and methods Patients with acute and sub-acute (<30 days) lower limb ischaemia were randomised following angiography. Group 1 (n=58) received pulse-spray infusion of recombinant plasminogen activator (rt-PA, 15 mg/h) for 2 h followed by low-dose infusion if needed. Group 2 (n=63) were only treated with low-dose infusion (0.5 mg/h) of rt-PA for 48 h. Underlying lesions were corrected if required. Results The study was stopped prematurely. Complications were equally frequent in both groups. More than 75% lysis was accomplished in 78 versus 67% of the patients (p=0.21). Primary endpoints (re-occlusion, incomplete lysis, life-threatening complication, amputation, or death) were reached in 24 versus 32% of the patients (p=0.35). Neither vascular patency nor clinical parameters differed during the first year, but re-interventions tended to be more frequent (p=0.040 at 1 month; p=0.090 at 1 year) and of a greater magnitude (p=0.028) in group 2. Conclusions There was no obvious advantage with initial high-dose thrombolysis, which may be a type-2 error. A reduction of major re-interventions was recorded. Objectives To test if initial high-dose, pulse-spray thrombolysis improves the early and late outcome of lower limb ischaemia as compared with low-dose infusion alone. Design Prospective randomised multicentre study. Material and methods Patients with acute and sub-acute (<30 days) lower limb ischaemia were randomised following angiography. Group 1 (n=58) received pulse-spray infusion of recombinant plasminogen activator (rt-PA, 15 mg/h) for 2 h followed by low-dose infusion if needed. Group 2 (n=63) were only treated with low-dose infusion (0.5 mg/h) of rt-PA for 48 h. Underlying lesions were corrected if required. Results The study was stopped prematurely. Complications were equally frequent in both groups. More than 75% lysis was accomplished in 78 versus 67% of the patients (p=0.21). Primary endpoints (re-occlusion, incomplete lysis, life-threatening complication, amputation, or death) were reached in 24 versus 32% of the patients (p=0.35). Neither vascular patency nor clinical parameters differed during the first year, but re-interventions tended to be more frequent (p=0.040 at 1 month; p=0.090 at 1 year) and of a greater magnitude (p=0.028) in group 2. Conclusions There was no obvious advantage with initial high-dose thrombolysis, which may be a type-2 error. A reduction of major re-interventions was recorded.
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