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Thrombolysis in peripheral arterial graft occlusion
1Department of Surgery, University of South Florida College of Medicine, Tampa.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|August 1, 1993
Summary
Acute thrombosis of lower extremity arterial bypass grafts threatens limb viability. Vascular surgeons must weigh thrombolysis, thrombectomy, and replacement, considering anticoagulants for PTFE grafts and selected vein grafts.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Acute thrombosis of lower extremity arterial bypass grafts is a major cause of limb loss.
- Graft salvage presents significant challenges for vascular surgeons.
Purpose of the Study:
- To review treatment options for acute arterial bypass graft thrombosis.
- To discuss the role of anticoagulation and thrombolysis in graft salvage.
Main Methods:
- Review of current literature on acute graft thrombosis management.
- Analysis of treatment strategies including thrombolysis, thrombectomy, and graft replacement.
Main Results:
- Oral anticoagulants are recommended for low-flow polytetrafluoroethylene (PTFE) grafts and post-thrombolysis.
- Thrombolytic therapy may be effective for occluded vein grafts presenting within 48 hours with correctable stenosis.
Conclusions:
- Management of acute graft thrombosis requires careful consideration of multiple treatment modalities.
- Anticoagulation and timely thrombolysis play key roles in successful graft salvage.