Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism

• Published in: Journal of feline medicine and surgery 2022-12, Vol.24 (12), p.e535-e545
• Main Authors: Guillaumin, Julien, DeFrancesco, Teresa C, Scansen, Brian A, Quinn, Rebecca, Whelan, Megan, Hanel, Rita, Goy-Thollot, Isabelle, Bublot, Isabelle, Robertson, James B, Bonagura, John D
• Format: Article
• Language: English
• Subjects: Animals; Anticoagulants; Cat Diseases - drug therapy; Cats; Life Sciences; Original; Prospective Studies; Research Design; Tissue Plasminogen Activator - therapeutic use; Venous Thromboembolism - veterinary
• ISSN: 1098-612X; 1532-2750; 1532-2750
• DOI: 10.1177/1098612X221135105

Objectives The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). Methods Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher’s exact, Student’s t- and Mann–Whitney–Wilcoxon tests. Results Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [P = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups (P