Factors affecting initial and 6 month patency rates after intraarterial thrombolysis with high dose urokinase.

Eighty-five patients who underwent 100 transcatheter intraarterial thrombolytic infusions for occlusions of suprainguinal and infrainguinal grafts and arteries were analyzed to determine the initial and 6 month results. Analysis demonstrated that suprainguinal occlusions of arteries and grafts were most likely to both lyse (89 percent) and remain patent for 6 months (86 percent). Arteries and graft occlusions had approximately the same incidence of thrombolytic recanalization (79 percent versus 74 percent). Arteries, however, had a higher incidence of 6 month patency than grafts (71 percent versus 41 percent). The inability to clear all flow-limiting lesions from the reopened portion of the vascular tree makes it highly likely that reocclusion will occur before 6 months. As a group, infrainguinal synthetic bypass grafts had the lowest patency rate at 6 months (26 percent), and suprainguinal arteries the highest rate (92 percent).