Fibrinolytic intra-arterial therapy in treatment of arterial occlusion in femoropopliteal segment.

AIM

Local intra-arterial thrombolysis is one of the methods of treatment of acute ischemia of extremities. Its aim is rapid restoration of arterial patency and the reperfusion of the ischemic extremity. It allows the identification of the cause of arterial occlusion. Identification and description of arterial wall lesions informs decisions optimizing further therapy, either surgical or endovascular.

METHODS

From 2003 to 2005, 17 patients with femoro-popliteal occlusion were treated with local intra-arterial thrombolysis. All patients underwent color Doppler examination followed by angiography, which confirmed the diagnosis. A catheter was introduced through a femoral artery puncture and its tip was wedged against the thrombus or within its mass. All patients received streptokinase. The progress of thrombolysis was monitored by repeated angiography and treatment was continued for up to 6 h after the radiographically confirmed restoration of patency of the artery.

RESULTS

In 15 (88%) treated patients we restored patency of the previously occluded artery and obtained complete remission of symptoms of lower limb ischemia.

CONCLUSION

Local intra-arterial thrombolysis is a safe and effective method of treating lower limb ischemia in selected patients. It allows one to decrease the total dose of thrombolytic agent and it is a good alternative for surgical procedure.