[Medicamentous thrombolysis in acute occlusions of extremity arteries]

Local catheter-directed thrombolysis for thromboembolic extremity artery or bypass occlusions is a promising therapeutic option with comparatively low complication rates if the severity of the ischemia does not require an urgent surgical revascularization. This therapeutic decision has to be made by the vascular team under consideration of individual circumstances and contraindications. Apart from an adequate dosage, a strict intrathrombotic application of the fibrinolytic agent and careful clinical monitoring, including surveillance of the coagulation system is necessary. If needed, the thrombolysis therapy can be combined with interventional thrombaspiration and balloon dilatation or surgical correction of an underlying lesion.