Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients
Abstract Background Effective and innovative treatment for patients with acute lower-extremity deep venous thrombosis (DVT) is lacking. This study explored the use of recombinant human pro-urokinase (rhPro-UK) in catheter-directed thrombolysis for acute DVT patients. Methods A retrospective analysis...
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BMC
2025-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04800-x |
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| author | Tao Ma Cangtuo Li Guang Song Shaoxin Yao |
| author_facet | Tao Ma Cangtuo Li Guang Song Shaoxin Yao |
| author_sort | Tao Ma |
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| description | Abstract Background Effective and innovative treatment for patients with acute lower-extremity deep venous thrombosis (DVT) is lacking. This study explored the use of recombinant human pro-urokinase (rhPro-UK) in catheter-directed thrombolysis for acute DVT patients. Methods A retrospective analysis included 85 acute DVT patients undergoing CDT from January 2021 to December 2023. Patients were divided into an observation group (n = 43, rhPro-UK) and a control group (n = 42, UK). Outcomes assessed included total effective rate, venous patency score, limb circumference differences, coagulation parameters (PT, APTT, Fg), adverse events (BARC criteria), and post-thrombotic syndrome (PTS) incidence at 6 months (Villalta scale). Results The observation group treated with rhPro-UK demonstrated superior clinical outcomes compared to the control group receiving urokinase. The total effective rate was significantly higher in the rhPro-UK group (P = 0.011), with improved venous patency reflected by a lower post-treatment patency score (P = 0.009) and higher patency rate (80.86% vs. 72.86%, P = 0.045). Limb swelling reduction was more pronounced in the rhPro-UK group, evidenced by smaller thigh (P = 0.002) and calf circumference differences (P = 0.001). Coagulation function improved significantly, with prolonged PT (P = 0.002) and APTT (P = 0.001), alongside reduced fibrinogen levels (P < 0.001). Safety outcomes favored rhPro-UK, with fewer total bleeding events (14.29% vs. 4.65%, P = 0.039) and no major bleeding (BARC Type 3) observed. At 6-month follow-up, the rhPro-UK group exhibited a markedly lower incidence of post-thrombotic syndrome (9.3% vs. 26.2%, P = 0.034) and sustained venous patency, confirming its long-term efficacy. Conclusion CDT with rhPro-UK significantly improves venous patency, reduces limb swelling, optimizes coagulation function, and minimizes complications compared to UK. Its fibrin-targeted mechanism enhances clinical efficacy and safety, supporting its adoption as a superior thrombolytic for acute DVT. Trial registration Not applicable. |
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| institution | Kabale University |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-8b83a1d1b9b347d8bf6a8cd9ca88842d2025-08-20T03:45:22ZengBMCBMC Cardiovascular Disorders1471-22612025-04-012511910.1186/s12872-025-04800-xExploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patientsTao Ma0Cangtuo Li1Guang Song2Shaoxin Yao3Intervention Department, Tangshan Gongren HospitalIntervention Department, Tangshan Gongren HospitalIntervention Department, Tangshan Gongren HospitalIntervention Department, Tangshan Gongren HospitalAbstract Background Effective and innovative treatment for patients with acute lower-extremity deep venous thrombosis (DVT) is lacking. This study explored the use of recombinant human pro-urokinase (rhPro-UK) in catheter-directed thrombolysis for acute DVT patients. Methods A retrospective analysis included 85 acute DVT patients undergoing CDT from January 2021 to December 2023. Patients were divided into an observation group (n = 43, rhPro-UK) and a control group (n = 42, UK). Outcomes assessed included total effective rate, venous patency score, limb circumference differences, coagulation parameters (PT, APTT, Fg), adverse events (BARC criteria), and post-thrombotic syndrome (PTS) incidence at 6 months (Villalta scale). Results The observation group treated with rhPro-UK demonstrated superior clinical outcomes compared to the control group receiving urokinase. The total effective rate was significantly higher in the rhPro-UK group (P = 0.011), with improved venous patency reflected by a lower post-treatment patency score (P = 0.009) and higher patency rate (80.86% vs. 72.86%, P = 0.045). Limb swelling reduction was more pronounced in the rhPro-UK group, evidenced by smaller thigh (P = 0.002) and calf circumference differences (P = 0.001). Coagulation function improved significantly, with prolonged PT (P = 0.002) and APTT (P = 0.001), alongside reduced fibrinogen levels (P < 0.001). Safety outcomes favored rhPro-UK, with fewer total bleeding events (14.29% vs. 4.65%, P = 0.039) and no major bleeding (BARC Type 3) observed. At 6-month follow-up, the rhPro-UK group exhibited a markedly lower incidence of post-thrombotic syndrome (9.3% vs. 26.2%, P = 0.034) and sustained venous patency, confirming its long-term efficacy. Conclusion CDT with rhPro-UK significantly improves venous patency, reduces limb swelling, optimizes coagulation function, and minimizes complications compared to UK. Its fibrin-targeted mechanism enhances clinical efficacy and safety, supporting its adoption as a superior thrombolytic for acute DVT. Trial registration Not applicable.https://doi.org/10.1186/s12872-025-04800-xAcute lower extremity deep venous thrombosisCatheter-directed thrombolysisRecombinant human pro-urokinaseVenous patency of affected limbLimb circumference difference |
| spellingShingle | Tao Ma Cangtuo Li Guang Song Shaoxin Yao Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients BMC Cardiovascular Disorders Acute lower extremity deep venous thrombosis Catheter-directed thrombolysis Recombinant human pro-urokinase Venous patency of affected limb Limb circumference difference |
| title | Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| title_full | Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| title_fullStr | Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| title_full_unstemmed | Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| title_short | Exploring the efficacy of recombinant human pro-urokinase in catheter-directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| title_sort | exploring the efficacy of recombinant human pro urokinase in catheter directed thrombolysis for acute lower extremity deep venous thrombosis patients |
| topic | Acute lower extremity deep venous thrombosis Catheter-directed thrombolysis Recombinant human pro-urokinase Venous patency of affected limb Limb circumference difference |
| url | https://doi.org/10.1186/s12872-025-04800-x |
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