小儿左心导管术后股动脉血栓形成的溶栓治疗

Objective The study was conducted to investigate the feasibility and effectiveness of fibrinolytic therapy for femoral artery thrombosis after left cardiac catheterization in children. Methods Thrombolytic therapy with urokinase was applied in 16 children (5 males) with femoral artery thrombosis after left cardiac catheterization. Patients were given a bolus injection of heparin, 100 U/kg. 30 000-100 000 U boluses of urokinase were injected intravenously, and then a continuous infusion of 10 000-50 000 U/h was started. Transcatheter thrombolysis was performed once previous procedures failed. Results All 16 patients presented lower limbs ischemia after left cardiac catheterizations. The age was (2. 6 ± 1.9) years,the height was (85.3 ± 13. 1) cm, the weight was (11.2 ±3.8) kg. Patients with cynosic and acynusic congenital heart disease were 2 and 14, respectively. Interventional therapy was performed in 12 patients. Absent arterial pulsations were found in 15 patients and reduced arterial pulsation in 1 patient. Femoral arterial perfusion became normal in all patients (3 after transcatheter thrombolysis, 11 post intravenous thrombolysis and 2 post intravenous heparin). The average doses of heparin and urokinase were (950 ±682)U and (295 357 ± 198 770)U. The average duration of therapy was (7.25 ±5.31 )h. Mild residual stenosis were found in 2 patients post various treatments. Conclusion Fibrinolytic therapy with urokinase is a safe and useful medality for children with femoral artery thrombosis after left cardiac catheterization.

Fibrinolytic therapy for femoral artery thrombosis after left cardiac catheterization in children