Continuous local intra-arterial infusion of antithrombotic agents for replantation (comparison with intravenous infusion)

Abstract

The success rate of replantation of amputated digits and limbs appears to be improved by local continuous intra-arterial infusion of urokinases, heparin and PGE1 at a daily dose of 240,000 I.U., 10,000 U, and 40 micrograms, respectively, for ten days, in comparison to intravenous infusion of the drugs. The purpose of this study was to investigate the difference between the haematological effects of intra-arterial and intravenous infusion. Accordingly coagulation and fibrinolytic enzyme levels were examined before, and at 4 and 12 hours after the start of infusion and on the 3rd and 10th postoperative days. Intra-arterial infusion was advantageous over intravenous infusion probably because the effect of general metabolism on drug levels was small, drugs exhibited immediate action and efficacy was localised. No particular side effects were demonstrated.