Local thrombolytic therapy as a support for catheter embolectomy in limb arterial occlusions

Eleven patients with acute arterial occlusion of the lower limb were treated by standard balloon catheter embolectomy. Residual thrombus seen in intraoperative arteriograms was treated with streptokinase: after an initial dose of 10.000 IU, streptokinase was infused intra-arterially in a dose of 5.000-10.000 IU/hour. The average infusion time was 40 hours (range 15-94 hours) and the total amount of streptokinase used was on average 210.000 IU (range 35.000-470.000 IU). All legs were saved. Complete recanalization occurred in eight patients and partial recanalization in three patients. Excluding three inguinal haematomas no other complications occurred.