Transcatheter intracavitary fibrinolysis of loculated pleural effusions : Experience in 102 patients

To assess the efficacy of intrapleural urokinase instillation through small-caliber catheters for the treatment of loculate and/or septate effusions. We inserted small-caliber catheters (8.2 Fr) in 102 patients with septate and/or loculate pleural effusions using ultrasonographic guidance. Urokinase...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 1999-03, Vol.22 (2), p.114-118
Main Authors: DE GREGORIO, M. A, RUIZ, C, ALFONSO, E. R, FERNANDEZ, J. A, MEDRANO, J, ARINO, I
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Catheterization - methods
Catheters
CHEST
Complications
DIMERS
Drainage
ETIOLOGY
Female
Fibrin
FIBRINOLYSIS
Fluoroscopy
Humans
Instillation, Drug
Male
Medical instruments
Medical sciences
Middle Aged
PATIENTS
Pharmacology. Drug treatments
Placement
Plasminogen Activators - administration & dosage
Pleural effusion
Pleural Effusion - diagnostic imaging
Pleural Effusion - drug therapy
Pleural Effusion - etiology
RADIOLOGY AND NUCLEAR MEDICINE
Recurrence
Surgical drains
Tomography, X-Ray Computed
Treatment Outcome
U-Plasminogen activator
Ultrasonography
UROKINASE
Urokinase-Type Plasminogen Activator - administration & dosage
Wound drainage
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Summary:To assess the efficacy of intrapleural urokinase instillation through small-caliber catheters for the treatment of loculate and/or septate effusions. We inserted small-caliber catheters (8.2 Fr) in 102 patients with septate and/or loculate pleural effusions using ultrasonographic guidance. Urokinase (100,000 IU/2 hr, 3 times a day) was instilled through the catheter until the effusion resolved and D-dimer levels were 2 mm). Two patients died from unrelated causes within 30 days after catheter placement. Complications were seen in 13 patients (12.74%): hydropneumothorax, nine cases (8.82%); infection of the puncture point, three cases (2.94%); and adverse reaction, one case (0.98%). No further treatment was required. The use of intrapleural fibrinolytic agents delivered through small-caliber catheters for the treatment of loculate and/or septate pleural effusion is a simple, effective, minimally invasive and inexpensive procedure that can prevent sequelae and shorten drainage time.
ISSN:0174-1551
1432-086X
DOI:10.1007/s002709900345