[Local intra-arterial thrombolysis in acute ischemia of an extremity]

The effect of intra-arterial local thrombolysis or peripheral arterial occlusions seems to be well documented. As assessed by angiography, primary recanalisation is achieved in 65-90%. Using recombinant tissue plasminogen activator thrombolysis is achieved more frequently (90% vs 65-85%) and faster (4-8 hours vs 12-48 hours) than when using streptokinase or urokinase. The most frequently used dosages are streptokinase 5000 IU/h, and recombinant tissue plasminogen activator 0.5 mg/h. So far, results from randomized trials between thrombolytic therapy and surgery have not been published.