[Atherosclerosis obliterance; thrombolytic therapy]

Thrombolytic therapy used to be considered ineffective for chronic arteriosclerotic obiterance. However, direct infusion of a thrombotic agent into the thrombus through a vascular catheter was shown to be more effective than expected. We have performed high-dose intra-thrombotic urokinase injection for arteriosclerotic obiterance of iliac and femoropopliteal arterial region since 1985. In this procedure, urokinase is infused at 10,000 unit/ minute through a catheter inserted into the thrombus. In the 65 lesions treated by this method, the initial success rate was 85%, and the cumulative 1-year patency rate was 72%. The mean total dose of urokinase was 620,000 units. Here we discussed thrombolytic therapy for chronic arteriosclerosis obliterance based on our experience.