Comerota Anthony J, Sidhu Ramandeep
Jobst Vascular Center, The Toledo Hospital, Toledo, OH 43606, USA.
Semin Vasc Surg. 2009 Mar;22(1):47-51. doi: 10.1053/j.semvascsurg.2009.01.004.
Catheter-directed thrombolytic therapy is a well-accepted treatment modality for acute arterial and graft occlusion, but intraoperative use of plasminogen activators as an adjunct to operative thrombectomy or thromboembolectomy is frequently overlooked by vascular surgeons. Evidence exists that intraoperative intraarterial infusion of lytic agents is safe and is accompanied by breakdown of distal thrombus. This article describes the rationale for intraoperative thrombolysis, reviews the evidence supporting its use, and suggests several technical approaches to incorporating lytic therapy intraoperatively.
导管定向溶栓疗法是治疗急性动脉闭塞和移植物闭塞的一种广泛接受的治疗方式，但血管外科医生常常忽视术中使用纤溶酶原激活剂作为手术血栓切除术或血栓栓子切除术的辅助手段。有证据表明，术中动脉内输注溶栓药物是安全的，并且会伴有远端血栓的溶解。本文描述了术中溶栓的基本原理，回顾了支持其使用的证据，并提出了几种术中纳入溶栓治疗的技术方法。
