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

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

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Published in:Cardiovascular and interventional radiology 1999-03, Vol.22 (2)
Main Authors: De Gregorio, Miguel A., Ruiz, Carlos, Alfonso, Eduardo R., Fernandez, Jose A., Medrano, Joaquin, Arino, Ignacio
Format: Article
Language:English
Subjects:
BLOOD COAGULATION FACTORS
CHEMICAL REACTIONS
DECOMPOSITION
DIAGNOSTIC TECHNIQUES
DIFFUSION
DRAINAGE
DRUGS
ENZYMES
FAILURES
FIBRINOLYSIS
FIBRINOLYTIC AGENTS
HEMATOLOGIC AGENTS
HYDROLASES
MEDICAL SUPPLIES
NONSPECIFIC PEPTIDASES
ORGANIC COMPOUNDS
PEPTIDE HYDROLASES
PROSTHESES
PROTEINS
PROTEOLYSIS
RADIOLOGY AND NUCLEAR MEDICINE
TUBES
ULTRASONOGRAPHY
UROKINASE
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Summary:Purpose: To assess the efficacy of intrapleural urokinase instillation through smll-caliber catheters for the treatment of loculate and/or septate effusions.Methods: 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.Conclusions: 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