PROSPECTIVE RANDOMIZED COMPARATIVE-STUDY OF PULSE-SPRAY AND CONVENTIONAL LOCAL THROMBOLYSIS

Objectives: To compare the rime required to achieve lysis with the pulse spray technique and the conventional slow continuous infusion technique. Design: Prospective randomised open Study. Methods: Eighteen patients suitable for intra-arterial thrombolytic therapy with conventional and pulse spray technique were randomised 1:1 to receive either pulse spray thrombolysis with 0.33 mg/ml rt-PA injected as a bolus of 0.2 ml or conventional thrombolysis with 0.05 mg/ml rt-PA infused at a rate of 10 ml/h. Results: The age, duration of symptoms, length of occlusion and prethrombolysis ankle brachial pressure index were comparable in the two groups. The median duration of thrombolytic therapy in the pulse spray group was 195 min (range 90-1260) compared to 1390 min (range 300 - 2400) in the Conventional group. The difference between the two groups was significant, p<0.002 (Mann-Whitney test). Conclusions: Significantly shorter lime is required to achieve local thrombolysis with pulse spray compared to the conventional infusion method.