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Urokinase thrombolysis in acute-on-chronic vascular occlusion of lower limb

Chandra P Shrivastava1, Sanjeev Devgarha

  • 1Department of Cardiothoracic and Vascular Surgery, SMS Medical College & Hospital, H-16, Chitranjan Marg, C-Scheme, Jaipur-302001, Rajasthan, India. cps_sms@hotmail.com

Asian Cardiovascular & Thoracic Annals
|October 4, 2007
PubMed

Insights

Preoperative thrombolysis with urokinase significantly improved outcomes for patients with acute-on-chronic lower limb vascular occlusion, enhancing surgical success and long-term claudication distance.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Thrombolytic Therapy

Background:

  • Acute-on-chronic lower limb vascular occlusion presents a significant challenge in vascular surgery.
  • Thrombolysis is a potential treatment modality, but its impact on subsequent surgical outcomes requires further elucidation.

Purpose of the Study:

  • To evaluate the efficacy of preoperative thrombolysis using urokinase in patients with acute-on-chronic lower limb vascular occlusion.
  • To assess the impact of thrombolysis on the success of subsequent arterial surgical interventions and long-term patient outcomes.

Main Methods:

  • A cohort of 70 patients with acute-on-chronic lower limb vascular occlusion underwent thrombolysis with urokinase.
  • Patients were divided into responders (Group 1) and non-responders (Group 2) based on initial symptomatic improvement.
  • All patients subsequently underwent surgical intervention (polytetrafluoroethylene graft or arterioplasty).

Main Results:

  • Seventy-six percent of patients (53/70) showed symptomatic improvement with thrombolysis (Group 1).
  • A significantly higher proportion of Group 1 patients achieved a good response to surgical treatment (92%) compared to Group 2 (41%).
  • Improved claudication distance at 6 months was observed in 85% of Group 1 patients versus 38% of Group 2 patients.

Conclusions:

  • Preoperative thrombolysis with urokinase is an effectiveadjunct in managing acute-on-chronic lower limb vascular occlusion.
  • Thrombolysis improves the success rate of subsequent arterial surgery and enhances long-term functional recovery.
  • Symptomatic response to thrombolysis predicts a favorable outcome following surgical intervention.

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