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Thrombolytic therapy with heparin-hemoclar∗ association
Suppl. VI,
1986
THROMBOSIS
RESEARCH
107
210 DOES PHLEBOGRAPHY PERMIT THE PREDICTION OF THE EFFICIENCY OF THE THROMBOLYTIC THERAPY ? JL Bouvier, G Le Corff, A Elias, C Audebert, A Serradimigni . CHU TIMONE 13385 MARSEILLE (FRANCE) With a series of twenty-five patients, radiological criteria was defined predicting good therapeutic results. All of them were treated with streptokinase intravenously (100,000 IU/hrs during at least 48 hrs) for a recent veinous thrombosis (less than ten days) and with a prolonged efficient, precocious biological fibrinolysis. For each impaired vein (22 iliacs, 17 femorals, 8 popliteals) the initial phlebographic aspect was classed as I) a complete obstruction (CO) ; 2) an incomplete obstruction (IO) ; 3) incomplete obstruction with dilation (D) : a superior veinous diamater of 1 mm in relationship to the controlateral segment. The results of the treatment were verified by a phlebography performed on the average of the fifth day and classed for each vein : complete healing, improvement or failure. Healing is more frequently obtained when there is an D than with CO (p
211 THF0mLYTIC THEXAPY WITH HEARIN-ASSOCIATION.J.J. Pinot, B. Poutiere,I). Arnoux, L. Horvath,P. Benchimol,J. Sanpol. H6p. Cantiniand Lab. Hematologie , %p. Conception- 13385Marseillecedex 5 - glance.
In our experience,potentialisation of Heparin activityby Hencclar*became suspect due to hemorrhagicaccidentsoccuringwhen this bitherapyhad exceptionally been applied.A prospective study was thereforeundertakento determinea curativedosage avoidingthe risks of hemorrhage.10 patientswere treated : 3 thranbo-phlebitis, 3 recent iliac-thranbosis, 3 lower-limbembolism=! and 1 fenoro-popliteal thranbosis. CanbinedHeparin-Henoclar* was given intravenously. Althoughmoderate,the doses used (depending on PIT, PT and blood level of Heparin)were alwayseffectiveanticoagulants. They ranged frun 30 to 100 mg Heparinand 30 to 100 mg Hemoclar*daily. Clinicalimprovement was always noticed in less than 24 hours. An old fenoro-poplitesl enbolisnand a long femoralthranbosis were not modifiedfran the angiographic point of vue. On the contrary,the radiological controlof 3 phlebitisshoweda considerable decreasein thrantusvolume over 2 weeks. Iliacthranhosisand the 2 femoro-pop1itea.l embolimnsgraduallydecreasedwith canpleteradiological cure after 2 weeks.We found no significant changein fibrinolysis blood parameters. The results show that canbinedHeparin-Henoclar * makes it possibleto dissolvethranbi of large volumeparticularly in the case of recentones.
1986
THROMBOSIS
RESEARCH
107
210 DOES PHLEBOGRAPHY PERMIT THE PREDICTION OF THE EFFICIENCY OF THE THROMBOLYTIC THERAPY ? JL Bouvier, G Le Corff, A Elias, C Audebert, A Serradimigni . CHU TIMONE 13385 MARSEILLE (FRANCE) With a series of twenty-five patients, radiological criteria was defined predicting good therapeutic results. All of them were treated with streptokinase intravenously (100,000 IU/hrs during at least 48 hrs) for a recent veinous thrombosis (less than ten days) and with a prolonged efficient, precocious biological fibrinolysis. For each impaired vein (22 iliacs, 17 femorals, 8 popliteals) the initial phlebographic aspect was classed as I) a complete obstruction (CO) ; 2) an incomplete obstruction (IO) ; 3) incomplete obstruction with dilation (D) : a superior veinous diamater of 1 mm in relationship to the controlateral segment. The results of the treatment were verified by a phlebography performed on the average of the fifth day and classed for each vein : complete healing, improvement or failure. Healing is more frequently obtained when there is an D than with CO (p
211 THF0mLYTIC THEXAPY WITH HEARIN-ASSOCIATION.J.J. Pinot, B. Poutiere,I). Arnoux, L. Horvath,P. Benchimol,J. Sanpol. H6p. Cantiniand Lab. Hematologie , %p. Conception- 13385Marseillecedex 5 - glance.
In our experience,potentialisation of Heparin activityby Hencclar*became suspect due to hemorrhagicaccidentsoccuringwhen this bitherapyhad exceptionally been applied.A prospective study was thereforeundertakento determinea curativedosage avoidingthe risks of hemorrhage.10 patientswere treated : 3 thranbo-phlebitis, 3 recent iliac-thranbosis, 3 lower-limbembolism=! and 1 fenoro-popliteal thranbosis. CanbinedHeparin-Henoclar* was given intravenously. Althoughmoderate,the doses used (depending on PIT, PT and blood level of Heparin)were alwayseffectiveanticoagulants. They ranged frun 30 to 100 mg Heparinand 30 to 100 mg Hemoclar*daily. Clinicalimprovement was always noticed in less than 24 hours. An old fenoro-poplitesl enbolisnand a long femoralthranbosis were not modifiedfran the angiographic point of vue. On the contrary,the radiological controlof 3 phlebitisshoweda considerable decreasein thrantusvolume over 2 weeks. Iliacthranhosisand the 2 femoro-pop1itea.l embolimnsgraduallydecreasedwith canpleteradiological cure after 2 weeks.We found no significant changein fibrinolysis blood parameters. The results show that canbinedHeparin-Henoclar * makes it possibleto dissolvethranbi of large volumeparticularly in the case of recentones.