[Selective intra-arterial thrombolysis in acute limb ischemia]

Despite significant advances in modern treatment of patients with peripheral artery disease, acute limb ischemia remains highly prevalent, limb-threatening, and potentially fatal, continuing to pose a challenge to vascular surgeons. Currently, there are various approaches to managing patients with acute limb ischemia. Selective intra-arterial thrombolysis is an acceptable alternative to surgical treatment. To date, the main indications, advantages and complications of thrombolysis have been identified. Searching for prognostic risk factors for the development of hemorrhagic complications and the likelihood of adverse outcomes after selective intra-arterial thrombolysis can help in choosing a treatment method for patients with this disease. However, despite the introduction of new thrombolytic drugs and improved infusion techniques of selective intra-arterial thrombolysis, the long-term results of vascular patency have not significantly improved and are in fact comparable to those in the urokinase era. Therefore, the prevention of reocclusion by means of additional pharmacological agents is an area that is under development and is being actively studied using numerous approaches, including the use of modern anticoagulant and antiplatelet drugs.