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Catheter-directed intra-arterial thrombolysis for lower extremity arterial occlusions

Yılmaz Güneş1, Isa Sincer1, Emrah Erdal1

  • 1Department of Cardiology, Faculty of Medicine, Abant İzzet Baysal University; Bolu-Turkey.

Anatolian Journal of Cardiology
|August 4, 2019
PubMed

Insights

Catheter-directed intra-arterial thrombolysis (CDT) offers immediate vessel patency for limb salvage in lower extremity artery occlusions. Treatment selection for CDT depends on individual patient factors and lesion characteristics.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Lower extremity artery occlusions, including bypass grafts, can lead to salvageable limb ischemia.
  • Acute, subacute, and some chronic occlusions are potential indications for intervention.
  • Catheter-directed intra-arterial thrombolysis (CDT) is a recognized treatment option.

Purpose of the Study:

  • To review the role and application of CDT in managing lower extremity artery occlusions.
  • To highlight the potential benefits and considerations for CDT in limb salvage.

Main Methods:

  • Review of current literature and clinical practice regarding CDT for lower extremity occlusions.
  • Discussion of patient selection criteria, including limb viability and lesion characteristics.
  • Consideration of thrombolytic agents, dosing, and technical approaches.

Main Results:

  • CDT can achieve immediate vessel patency in many patients, particularly those with fresh thrombus or emboli.
  • The procedure is associated with an acceptable complication rate.
  • CDT can serve as an adjuvant therapy for endovascular interventions in chronic occlusions.

Conclusions:

  • CDT is a rational treatment for salvageable limb ischemia due to lower extremity artery occlusions.
  • Individualized treatment strategies are crucial, considering limb viability, lesion characteristics, and hemorrhage risk.
  • Standardization of CDT techniques and protocols is lacking.

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