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[Local lysis therapy in acute arterial thrombosis]
F J Roth1, R Rieser, A Scheffler
1Aggertalklinik, Engelskirchen.
Langenbecks Archiv Fur Chirurgie. Supplement II, Verhandlungen Der Deutschen Gesellschaft Fur Chirurgie. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1990
Summary
Acute thrombotic arterial occlusion, a complication of chronic vascular disease, is best treated with a combination of low-dose fibrinolysis, aspiration embolectomy, and angioplasty. Ultrasound sonography is crucial to rule out aneurysms before fibrinolysis in popliteal occlusion cases.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Radiology
Context:
- Acute thrombotic arterial occlusion is a serious complication of chronic vascular arterial disease.
- Arteriography typically shows sudden occlusion and collateral vessels.
- Current treatments involve low-dose fibrinolytic therapy.
Purpose:
- To outline the optimal treatment strategy for acute thrombotic arterial occlusion.
- To highlight the importance of diagnostic imaging in specific cases.
- To emphasize the risks associated with certain patient profiles.
Summary:
- A combination approach using low-dose fibrinolysis, aspiration embolectomy, and angioplasty achieves the highest primary success rate.
- In cases of sudden popliteal occlusion with dilating arteriopathy, ultrasound sonography is essential to identify aneurysms.
- Aneurysms are a contraindication for fibrinolysis due to a high risk of peripheral embolization and severe arterial blood supply deterioration.
Impact:
- Improved patient outcomes through a multi-modal treatment approach.
- Reduced complications and enhanced safety by identifying contraindications prior to therapy.
- Better management of acute arterial occlusive events, particularly in the popliteal artery.