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Thrombolytic therapy in the treatment of peripheral arterial occlusions
1Department of Peripheral Vascular Disease, Cleveland Clinic Foundation, Ohio 44106.
Intra-arterial infusions of thrombolytic agents are useful adjuncts to surgery and percutaneous transluminal angioplasty. The best results occur when the thrombus is lysed within 30 days; however, successful thrombolysis has occurred up to four months after an arterial occlusion. Thrombolysis allows dissolution of thrombus in the small distal runoff vessels, decreasing outflow resistance and enabling the native artery or bypass graft to remain open longer. When native arteries are lysed successfully, an underlying area of stenosis is usually identified and thus able to be corrected with either surgery or percutaneous transluminal angioplasty. When bypass grafts thrombose, thrombolytic agents are usually successful in lysing the thrombus and identifying the cause for the thrombosis. With local intra-arterial infusions, side effects and complications may be kept to a minimum.
Intra-arterial infusions of thrombolytic agents are useful adjuncts to surgery and percutaneous transluminal angioplasty. The best results occur when the thrombus is lysed within 30 days; however, successful thrombolysis has occurred up to four months after an arterial occlusion. Thrombolysis allows dissolution of thrombus in the small distal runoff vessels, decreasing outflow resistance and enabling the native artery or bypass graft to remain open longer. When native arteries are lysed successfully, an underlying area of stenosis is usually identified and thus able to be corrected with either surgery or percutaneous transluminal angioplasty. When bypass grafts thrombose, thrombolytic agents are usually successful in lysing the thrombus and identifying the cause for the thrombosis. With local intra-arterial infusions, side effects and complications may be kept to a minimum.