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Related Experiment Videos

Errors and pitfalls in intraarterial thrombolytic therapy.

A Hirshberg1, J Schneiderman, A Garniek

  • 1Department of General and Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Journal of Vascular Surgery
|December 1, 1989
PubMed
Summary

Intraarterial thrombolytic therapy caused 60 complications in 122 patients. Addressing management errors, particularly bleeding and patient selection, is crucial for improving safety in this therapy.

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Area of Science:

  • Vascular Medicine
  • Interventional Radiology
  • Thrombolytic Therapy

Background:

  • Intraarterial thrombolytic therapy is used to dissolve blood clots.
  • Complications can arise during this procedure, necessitating careful management.
  • Understanding the patterns of complications is vital for improving patient outcomes.

Purpose of the Study:

  • To prospectively record and analyze complications of intraarterial thrombolytic therapy.
  • To identify underlying management errors contributing to these complications.
  • To provide recommendations for preventing future adverse events.

Main Methods:

  • Prospective recording of all complications during 138 courses of therapy in 122 patients over 5 years.
  • Analysis of complication types, including bleeding, vascular issues, and others.

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  • Identification and categorization of specific management errors.

    • Main Results:

    • Sixty complications were recorded, with 31 bleeding episodes and 15 vascular complications.
    • Management errors were identified in 27 complications, including mismanagement of bleeding (12), wrong patient selection (9), and protocol breaches (6).
    • Seven of the eight deaths were associated with complications stemming from management errors.

    Conclusions:

    • Intraarterial thrombolytic therapy is associated with significant risks and is not a low-risk alternative to surgery.
    • Focusing on identified management error patterns (bleeding, patient selection, protocol adherence) is key to reducing complications.
    • The therapy should be considered a prelude or alternative to surgery in carefully selected patients.