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Clot-Busters As Effective As Surgery To Clear Blockages In Legs

putation, whether patients received conventional surgical treatments or the drug. Moreover, the length of hospital stay was similar in the two groups. The team did notice an increased risk of bleeding in the urokinase group.

The clot-buster the team studied is an experimental compound known as recombinant urokinase. Standard urokinase, marketed as Abbokinase by Abbott, is approved to clear blood clots in the heart and lungs and is often used by physicians to treat blood clots in the legs. The overall cost of surgery and the cost of the medication are about the same, says Ouriel, noting that a typical supply of the drug for one patient costs the hospital about $3,500.

"For many surgeons today, the standard of care for these patients is to take them urgently to the operating room," says Ouriel. "Our results show that patients receiving urokinase can experience success rates equivalent to that of surgery, but the frequency and extent of open surgical procedures is reduced."

More than 30 percent of patients avoided open surgical procedures by using the drug, the physicians found. Of those taking the drug who then went on to have surgery, the operation was often less invasive than would have been required without the drug -- for instance, patching a narrow segment of an artery rather than placing a completely new bypass graft.

Even with all of these options -- drugs, surgery, or a combination -- about one-quarter of patients died or lost their leg within six months.

Ouriel says that in major medical centers, thrombolysis is often the first treatment patients receive, but word is just beginning to spread to all vascular surgeons.

"Instead of taking these patients to the operating room immediately, we can infuse a thrombolytic agent over a day or so," says Ouriel. "If we do need to operate, it's frequently a much smaller operation, such as patching one small area. Thrombolysis lets surgeons be selective in whom they operate o
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Contact: Tom Rickey
trickey@admin.rochester.edu
716-275-7954
University of Rochester
15-Apr-1998


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