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Thrombolytic therapy in an isolated limb

G R Goodman¹, S Tersigni, K Li

¹Department of Surgery, University of Utah School of Medicine, Salt Lake City 84132.

Annals of Vascular Surgery

|November 1, 1993

Summary

Isolated limb perfusion with thrombolytic agents enhances clot lysis and limb viability after failed thrombectomy. This technique achieves high drug concentrations locally, minimizing systemic bleeding risks and improving outcomes for acute limb ischemia.

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Area of Science:

Vascular Surgery
Thrombolytic Therapy
Ischemia Research

Background:

Intraoperative thrombolytic therapy aids thromboembolectomy but often causes incomplete lysis and bleeding.
Conventional methods struggle with systemic complications and limited efficacy.

Observation:

A novel technique involved infusing thrombolytic agents into a limb isolated by a tourniquet.
This isolated limb perfusion was tested in animal models and then in human patients.

Findings:

Animal studies showed high local thrombolytic concentrations without systemic effects.
In seven patients with failed thrombectomy, limb perfusion improved blood flow.
Five of seven treated limbs remained viable at 6 months with no systemic hemorrhage.

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Implications:

Isolated limb perfusion allows high-dose local thrombolysis, reducing systemic risks.
This method offers a promising strategy for limb salvage in acute limb ischemia.
It enables lysis of thrombi previously inaccessible to systemic or standard intraoperative therapies.