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Updated: Jul 11, 2025

Prehospital Thrombolysis: A Manual from Berlin
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CATHETER DIRECTED THROMBOLYSIS IN ACUTE LIMB ISCHEMIA PATIENTS. A SINGLE CENTER'S EXPERIENCE

Yurii M Hupalo1, Dmytro A Makivchuk1

  • 1STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|November 10, 2023
PubMed

Insights

Catheter-directed thrombolysis (CDT) effectively treats acute lower limb arterial thrombosis, significantly improving limb ischemia in most patients. This procedure is recommended for acute limb ischemia (ALI) patients with arterial thromboocclusion.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Acute lower limb arterial thrombosis leading to acute limb ischemia (ALI) is a critical condition.
  • Prompt intervention is crucial to prevent limb loss and improve patient outcomes.

Purpose of the Study:

  • To evaluate the effectiveness and outcomes of catheter-directed thrombolysis (CDT) for acute lower limb arterial thrombosis.
  • To assess the impact of CDT on limb salvage and patient recovery in ALI.

Main Methods:

  • A study involving 53 patients (17 female, 36 male, aged 53-76) with acute lower limb arterial thrombosis.
  • Patients presented with symptoms of ischemia, including pain, pallor, edema, and cyanosis.
  • Exclusion criteria included contracture, recent surgeries, and bleeding tendencies.

Main Results:

  • Catheter-directed thrombolysis (CDT) resulted in a 1-2 stage improvement in Rutherford classification for 97% of patients.
  • One patient (3%) experienced no improvement, leading to amputation.
  • Secondary angioplasty was performed in 40% of patients for residual steno-occlusive lesions.
  • One patient (3%) had recurrent thrombosis within a year, requiring revascularization.

Conclusions:

  • Catheter-directed thrombolysis (CDT) is a highly recommended treatment for patients experiencing acute limb ischemia (ALI) due to arterial thromboocclusion.
  • CDT demonstrates significant success in restoring blood flow and preventing amputation in the majority of ALI cases.
Abstract

Keywords:
limb survivinganticoagulant therapyarterial hypertensionmyocardial infarction (MI)revascularization

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