Regional low dosage thrombolytic therapy for peripheral arterial occlusions

This report describes successful management of recent peripheral arterial occlusions by intra-arterial low dosage thrombolytic drug infusions and percutaneous balloon angioplasty. An intra-arterial infusion of either streptokinase or urokinase at 1/20 of the usual systemic dose was delivered through an angiographic catheter into the region of the thrombus. Clot lysis was achieved for arterial occlusions of the iliac artery, an old aortofemoral graft limb and femoropopliteal arteries. Arterial clots of several weeks duration were lysed. Recurrent thrombosis can be prevented by anticoagulation, balloon angioplasty or surgical repair of causative arterial lesions. Thrombolytic therapy for arterial occlusions is not a replacement for surgical management but an important adjunct to the over-all treatment. Low dosage regional thrombolytic therapy deserves wider application in the management of selected arterial occlusions.