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Related Experiment Videos

Experience with pulse-spray technique in peripheral thrombolysis

S W Yusuf1, S C Whitaker, R H Gregson

  • 1Department of Vascular Surgery, University Hospital Nottingham, U.K.

European Journal of Vascular Surgery
|May 1, 1994
PubMed
Summary

Pulse-spray thrombolysis (PST) significantly reduces treatment time for acute limb ischemia. This accelerated technique achieved high rates of initial lysis and limb salvage in patients with critical limb ischemia.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Acute limb ischemia is a critical condition requiring rapid intervention to prevent tissue loss.
  • Conventional thrombolysis can be time-consuming, potentially delaying reperfusion.
  • The development of accelerated thrombolytic techniques is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of pulse-spray thrombolysis (PST) for treating peripheral arterial occlusions.
  • To compare the treatment duration of PST with conventional low-dose infusion thrombolysis.
  • To assess limb salvage and mortality rates associated with PST.

Main Methods:

  • PST was applied to 24 patients with limb ischemia, including severe cases with neurological deficits.

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  • Recombinant tissue plasminogen activator (rt-PA) was administered at a median dose of 18 mg.
  • Treatment outcomes, including lysis time, limb salvage, and mortality, were recorded and compared to historical data.

    • Main Results:

    • Complete initial lysis was achieved in 95.8% of patients.
    • Limb salvage at 30 days was 75%, with an overall 30-day mortality of 16.6%.
    • PST reduced lysis time by 11-fold compared to conventional methods (median 137.5 vs. 1512.5 minutes).

    Conclusions:

    • Pulse-spray thrombolysis is an effective and rapid method for treating acute limb ischemia.
    • PST offers a significant reduction in treatment time, potentially improving outcomes in limb-threatening ischemia.
    • This accelerated technique may become the preferred treatment for acute limb ischemia, especially in cases unsuitable for conventional thrombolysis.