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Diagnosing Acute Venous Thrombosis
TRAUMA TECHNOLOGY
Diagnosing Acute Venous Thrombosis he Food and Drug Administration has approved a new technology that can test for the presence of acute blood clots in lower-extremity deep veins.1 This product offers an advantage over methods such as ultrasonography, venography, or magnetic resonance imaging (MRI) in that it can distinguish new clots. AcuTect contains technetium Tc 99m and apcitide. Apcitide is a complex, custom-designed cyclic peptide that specifically binds to glycoprotein (GP) IIb/IIIa adhesion-molecule receptors found on activated platelets. Activated platelets are present in fresh clots (Figure). Because an acute thrombus can dislodge more easily and become an embolus, it is hypothesized that the ability to diagnose new
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If an acute thrombus is present, apcitide will bind to the GP IIb/IIIa receptors. clots will help clinicians recognize which clots are most dangerous and then determine appropriate therapy. AcuTect is provided as a kit that must be reconstituted by individuals licensed to use radioactive drugs. After preparation, the solution is injected into an upper-extremity vein, and imaging is conducted at 10 minutes and 60 minutes after injection. If an acute thrombus is present, apcitide will bind to the GP IIb/IIIa receptors. Scintigraphic imaging is used to detect asymmetric uptake between the 2 lower extremities. Adverse reactions
Figure. Diagram of a large activated platelet (large, rounded structure in lower-right corner). The GP IIb/IIIa receptors are on the surface of the platelet (appear as “U” shaped cups). The center receptor is filled with AcuTect. The long rod-shaped structure that extends from the AcuTect has technetium Tc 99m attached at the far end (in upper-left corner). (Diagram provided courtesy of Diatide, Inc, Londonderry, NH.)
associated with the use of AcuTect were reported to occur in 4.5% of the adults involved in clinical studies and included pain, headache, hypotension, or hypertension. REFERENCES 1. AcuTect consumer information. Food and Drug Administration Web site. Available at: http://www.fda.gov/cder/ consumerinfo/druginfo/Acutect. Accessed November 1999.
Int J Trauma Nurs 2000;6:30. Copyright © 2000 by the Emergency Nurses Association. 1075-4210/2000/$12.00 + 0 65/8/104328
30 INTERNATIONAL JOURNAL OF TRAUMA NURSING/Trauma Technology
VOLUME 6, NUMBER 1
Diagnosing Acute Venous Thrombosis he Food and Drug Administration has approved a new technology that can test for the presence of acute blood clots in lower-extremity deep veins.1 This product offers an advantage over methods such as ultrasonography, venography, or magnetic resonance imaging (MRI) in that it can distinguish new clots. AcuTect contains technetium Tc 99m and apcitide. Apcitide is a complex, custom-designed cyclic peptide that specifically binds to glycoprotein (GP) IIb/IIIa adhesion-molecule receptors found on activated platelets. Activated platelets are present in fresh clots (Figure). Because an acute thrombus can dislodge more easily and become an embolus, it is hypothesized that the ability to diagnose new
T
If an acute thrombus is present, apcitide will bind to the GP IIb/IIIa receptors. clots will help clinicians recognize which clots are most dangerous and then determine appropriate therapy. AcuTect is provided as a kit that must be reconstituted by individuals licensed to use radioactive drugs. After preparation, the solution is injected into an upper-extremity vein, and imaging is conducted at 10 minutes and 60 minutes after injection. If an acute thrombus is present, apcitide will bind to the GP IIb/IIIa receptors. Scintigraphic imaging is used to detect asymmetric uptake between the 2 lower extremities. Adverse reactions
Figure. Diagram of a large activated platelet (large, rounded structure in lower-right corner). The GP IIb/IIIa receptors are on the surface of the platelet (appear as “U” shaped cups). The center receptor is filled with AcuTect. The long rod-shaped structure that extends from the AcuTect has technetium Tc 99m attached at the far end (in upper-left corner). (Diagram provided courtesy of Diatide, Inc, Londonderry, NH.)
associated with the use of AcuTect were reported to occur in 4.5% of the adults involved in clinical studies and included pain, headache, hypotension, or hypertension. REFERENCES 1. AcuTect consumer information. Food and Drug Administration Web site. Available at: http://www.fda.gov/cder/ consumerinfo/druginfo/Acutect. Accessed November 1999.
Int J Trauma Nurs 2000;6:30. Copyright © 2000 by the Emergency Nurses Association. 1075-4210/2000/$12.00 + 0 65/8/104328
30 INTERNATIONAL JOURNAL OF TRAUMA NURSING/Trauma Technology
VOLUME 6, NUMBER 1