Abstract
OBJECTIVE: To investigate the clinical efficacy and safety of targeted artery infusion of Ginkgo biloba extract (GBE) combined with urokinase (URK) for treatment of thromboangiitis obliterans (TAO), and to provide a reference for the optimized treatment of TAO. METHODS: A total of 108 male TAO patients (December 2021-December 2023) were retrospectively enrolled and divided into a GBE group (54 cases, single GBE infusion) and a GBE-URK group (54 cases, GBE+URK infusion) after propensity score matching. Both groups received 72-hour continuous infusion, followed by standardized adjuvant therapy and 12-month follow-up. Key indices (pain, hemodynamics, inflammation) and safety/recurrence were compared. RESULTS: At 90 days, the GBE-URK group had lower FPS-R scores (1.89±0.84 vs 2.74±0.48, P<0.001), intermittent claudication scores (1.00±0.55 vs 1.69±0.61, P<0.001), and higher pain relief rate (94.44% vs 70.37%, P = 0.001). At 30 days, it had a higher ABI (1.14±0.22 vs 0.82±0.16, P<0.001), TBI (1.09±0.30 vs 0.76±0.26, P<0.001) and lower TNF-α (29.99±4.27 vs 39.99±5.14 pg/mL, P<0.001), ET-1 (189.85±19.20 vs 268.17±37.44 pg/mL, P<0.001). Adverse reaction rates were 7.41% vs 14.81% (P = 0.221); 12-month recurrence-free survival was higher in GBE-URK group (Log-rank P = 0.009). This was confirmed to be an independent factor by multivariable regression (P<0.05). CONCLUSIONS: GBE-URK infusion improves pain, hemodynamics, and long-term prognosis in TAO, providing a safe, minimally invasive strategy.