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Intra-arterial thrombolytic therapy in peripheral vascular disease
Surgery, Gynecology & Obstetrics
|July 1, 1987
Summary
Intra-arterial thrombolytic therapy effectively treats acute arterial occlusions, achieving lysis in most patients. Optimal outcomes depend on treatment duration and fibrinogen levels, with careful catheter placement minimizing complications.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Thrombolytic Therapy
Background:
- Arterial thromboses and emboli pose significant clinical challenges.
- Intra-arterial thrombolytic therapy offers a localized treatment approach.
Purpose of the Study:
- To evaluate the efficacy and safety of intra-arterial thrombolytic therapy for various arterial occlusions.
- To identify factors influencing treatment success and complications.
Main Methods:
- Prospective analysis of 34 patients treated with intra-arterial thrombolytic agents.
- Inclusion of diverse conditions: acute arterial thromboses, graft thromboses, arterial emboli, and pulmonary emboli.
Main Results:
- Successful lysis achieved in 27 of 34 patients (14 complete, 13 partial).
- Limb salvage rate of 75% (24 of 32 patients with extremity ischemia).
- Complications included hemorrhagic events (4/34) and distal emboli (6/34).
Conclusions:
- Intra-arterial thrombolytic therapy is a valuable treatment for acute arterial occlusion.
- Maintaining fibrinogen levels >50 mg% and appropriate catheter placement are crucial for safety and efficacy.
- Therapy is effective in the postoperative and intraoperative periods and for massive pulmonary embolism.