Combination of short- and long-term catheter thrombolysis for peripheral arterial occlusion

To save time and expenses we developed a combined program of local short-term catheter thrombolysis (CTL) in the angiographic laboratory followed by a long-term CTL on the ward if necessary to achieve patency. Out of 66 patients with arterial occlusion in the femoro-popliteal region the occluded segment was re-opened by short-term CTL alone in 22 patients (36%), and in 24 out of the remaining 44 patients by long-term CTL, giving a total primary success rate of 71%. Angiographic analysis showed that primary clinical success depended on the patency of run-off vessels in the calf after CTL. Complications occurred in five patients, necessitating surgical revision in only one. Two years after intervention 64% of the primarily recanalized arteries were still patent as shown by non-invasive examination.