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Thrombolysis in Acute Lower Limb Ischemia: Review of the Current Literature

Panagiotis G Theodoridis1, Constantinos H Davos2, Ilias Dodos1

  • 1Department of Vascular Surgery, "Konstantopouleio" General Hospital of Nea Ionia, Athens, Greece.

Annals of Vascular Surgery
|May 18, 2018
PubMed

Insights

Catheter-directed thrombolysis (CDT) offers a high success rate for acute limb ischemia (ALI), with most patients surviving without amputation. However, major complications remain a significant concern with this treatment.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Management

Background:

  • Catheter-directed thrombolysis (CDT) is a treatment option for acute limb ischemia (ALI).
  • A significant complication of CDT is severe bleeding, including systemic or intracranial hemorrhages.
  • This study evaluates the direct outcomes of CDT in ALI patients.

Purpose of the Study:

  • To assess the direct technical success rate of catheter-directed thrombolysis for acute limb ischemia.
  • To analyze the complication rates and patient outcomes, including survival and amputation, following CDT.
  • To provide a comprehensive overview of CDT's efficacy and risks in ALI management.

Main Methods:

  • A systematic literature search was conducted for studies on CDT in ALI up to December 2016.
  • Keywords used included "catheter direct thrombolysis" and "acute lower limb ischemia."
  • Data from 10 selected articles, encompassing 1,249 patients, were analyzed.

Main Results:

  • The overall technical success rate for CDT in ALI was 79.3%.
  • Major life-threatening complications occurred in 20.1% of patients, while minor complications affected 28.7%.
  • The 30-day survival rate without amputation was 88.5%, with a 4.2% mortality rate and 11.5% amputation rate.

Conclusions:

  • CDT demonstrates a high technical success rate in treating ALI.
  • A significant majority of patients treated with CDT survive without amputation within 30 days.
  • The high incidence of major complications is a notable disadvantage of CDT for ALI.
Abstract

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