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Vascular and Endovascular Surgery
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Intracranial Hemorrhage as the Synergistic Effect of Urokinase and Renal Dysfunction—A Case Report

Charles W. Wyble

University of Chicago, Illinois

Vasilios D. Karabinis

Department of Surgery, Hahnemann University School of Medicine, Philadelphia, Pennsylvania

Morris D. Kerstein

Department of Surgery, Hahnemann University School of Medicine, Philadelphia, Pennsylvania

This case report details a patient treated for a gangrenous toe by angioplasty, sympathectomy, and aortobifemoral grafting who arrived at the hospital with acute renal dysfunction and an occluded bypass graft. The patient had no abnormal results from coagulation studies and no absolute contraindications to urokinase therapy but died from intracranial hemorrhage. The authors believe that hemostatic system impairments related to renal dysfunction act synergistically with thrombolytic agents to produce abnormal bleeding. This case report suggests a synergistic interaction between acute renal dysfunction and urokinase therapy.

Vascular and Endovascular Surgery, Vol. 27, No. 5, 395-399 (1993)
DOI: 10.1177/153857449302700511
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