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Thrombolysis during the endovascular treatment of iliac artery occlusions

Giuseppe Taddei1, Paolo Tamellini, Faccioli Niccolo

  • 1Department of Radiology, Sacro Cuore Hospital, Negrar, Italy.

Diagnostic and Interventional Radiology (Ankara, Turkey)
|February 9, 2010
PubMed

Insights

Thrombolysis before percutaneous treatment significantly improves recanalization rates for iliac occlusions. This approach enhances the success of angioplasty and stenting in patients with claudication.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Iliac occlusions often lead to debilitating claudication.
  • Percutaneous treatments are standard, but challenging in occlusive disease.

Purpose of the Study:

  • To evaluate the therapeutic benefit of thrombolysis before angioplasty and stenting for iliac occlusions.
  • To determine if pre-procedural thrombolysis improves outcomes in iliac artery recanalization.

Main Methods:

  • Retrospective analysis of 28 iliac occlusion cases in 26 patients over six years.
  • Thrombolysis using urokinase-type plasminogen activator administered for an average of 28.2 hours.
  • Follow-up averaged 46.6 months to assess long-term outcomes.

Main Results:

  • Successful guidewire passage and thrombolysis achieved in 84% (21/25) of cases.
  • Complete thrombus dissolution and iliac axis recanalization occurred in all successfully treated cases.
  • 95% (20/21) of cases with complete thrombolysis proceeded to successful percutaneous treatment.

Conclusions:

  • Pre-procedural thrombolysis offers a potential advantage in treating atherosclerotic iliac artery occlusions.
  • This strategy may enhance the efficacy of subsequent percutaneous interventions like angioplasty and stenting.
Abstract

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