The combined use of transluminal angioplasty and selective clot lysis

14 cases of transluminal angioplasty and selective clot lysis are reported. One patient removed the catheter before successful lysis and one lost his leg after an almost complete lysis due to advanced necrosis. Treatment was successful in the other 12 cases with complete or partial thrombolysis. Remaining clots were either smashed by catheter and/or successfully treated by oral fibrinolytic therapy. The injected dose of streptokinase was 5,000 U/h after an initial dose of 20,000 U in one hand injection. The duration of infusions was 6-72 hours. A total dose of 60,000-520,000 U streptokinase was adopted. Intraarterial infusion therapy was followed by long-term low-grade fibrinolytic treatment with oral penthosan polysulphate. Four bleedings at the puncture site, one epistaxis and a bleeding at the site of a recently extracted tooth were seen. Only one infusion was stopped due to moderate bleeding and without any drawback.