A multilumen, multiple side hole infusion catheter was used for urokinase thrombolysis in 13 patients with thromboembolic occlusions of peripheral arteries and grafts. Balloon angioplasty was performed following urokinase infusion in 6 patients and atherectomy in 1 patient. There was one hemorrhagic complication. The major advantage of the multiple sidehole infusion catheter was the elimination of the need to reposition the catheter during the infusion and the reduction of the time burden on the angiographic facility. The success rate for the thrombolysis (77%) was comparable to results recorded in the literature. The total duration of infusion was not reduced compared to other series.

Adolescent↗

PubMedDate not supplied

Renal vein renin analysis: limitations of its use in predicting benefit from percutaneous angioplasty.

Two hundred forty-four consecutive patients (mean age 61 years), including 123 who had technically valid renal vein renin (RVR) analysis and 121 without RVR data, underwent technically successful percutaneous renal artery angioplasty (PTRA). They were retrospectively examined to evaluate the utility of RVR analysis in identifying renal hypertension (RVH), predicting benefit from PTRA, and determining if the lack of knowledge of renin levels significantly affected clinical outcome after PTRA. Abnormal RVR values were associated wtih clinical benefit after PTRA in 62 of 93 patients (67% sensitivity, 20% specificity, 72% positive predictive value). Clinical improvement following PTRA occurred in 31 of 37 patients with normal pre-PTRA RVR values (16% negative predictive value). RVR analysis correctly identified 86 of 117 patients with renovascular hypertension (74% sensitivity, 16% negative predictive value). Improved blood pressure (BP) control occurred in 72% with abnormal RVR analysis and 66% of the 121 patients without RVR data (p > 0.1). We conclude that the very low negative predictive value significantly limited the use of RVR analysis in this elderly (mean age 60 years) patient population with a high incidence of mild renal functional impairment (mean serum creatinine 1.4 mg/dl) and bilateral renal artery stenosis (38%). The lack of pre-PTRA renin data did not significantly affect clinical outcome. If RVR data were relied upon as the exclusive selection criterion in patients of this type, many would be prevented from having the benefit of cure or improvement by PTRA.

Angioplasty, Balloon↗

PubMedDate not supplied