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Correspondence
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Volume 339:564-565 August 20, 1998 Number 8
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A Comparison of Recombinant Urokinase with Vascular Surgery for Acute Arterial Occlusion of the Legs

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by Porter, J. M.
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by Ouriel, K.
To the Editor: The primary conclusion drawn by the authors of the Thrombolysis or Peripheral Arterial Surgery (TOPAS) trial (April 16 issue)1 was that recombinant urokinase reduced the need for open surgical procedures. It would have been remarkable if this were not the case, since the study design required the randomization of half the patients to open surgical procedures as the initial treatment. The authors apparently did not recognize that after the initial treatment, the urokinase group required a greater number of surgical procedures. The data presented suggest that most of these were open surgical procedures. If one counts all . . . [Full Text of this Article]

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