van Breda A, Robison J C, Feldman L, Waltman A C, Brewster D C, Abbott W M, Athanasoulis C A
J Vasc Surg. 1984 Jan;1(1):103-12.
Nineteen patients with 20 occluded arterial bypass grafts were treated with local infusion of streptokinase. Grafts treated included four aortofemoral graft limbs, 14 femoropopliteal or femorotibial grafts, one axillofemoral graft, and one transpubic femorofemoral graft. Complete lysis of thrombus was possible in 12 patients, partial lysis in five patients, and no lysis in two patients. Thrombolytic therapy was thought to be beneficial in the management of 14 patients. In two of these 14 only thrombolysis was required to restore and maintain graft patency, and in an additional two patients angioplasty was performed after thrombolytic therapy with no subsequent therapy necessary. In three patients who were initially poor operative risks, surgery could be postponed. Thrombolysis revealed the probable cause of thrombosis in 12 patients. Complications included four bleeding episodes, two of which were significant. There were no significant embolic complications. Unsuccessful thrombolytic therapy did not result in worsening of ischemia in any patient. Local infusion of thrombolytic agents is a useful adjunct in the management of occluded bypass grafts.
19例有20条动脉搭桥移植物闭塞的患者接受了链激酶局部灌注治疗。接受治疗的移植物包括4条主股动脉移植肢体、14条股腘动脉或股胫动脉移植物、1条腋股动脉移植物和1条经耻骨主股动脉移植物。12例患者的血栓完全溶解，5例部分溶解，2例未溶解。溶栓治疗被认为对14例患者的治疗有益。在这14例患者中，2例仅需溶栓即可恢复并维持移植物通畅，另外2例患者在溶栓治疗后进行了血管成形术，无需后续治疗。3例最初手术风险较高的患者，手术得以推迟。溶栓揭示了12例患者血栓形成的可能原因。并发症包括4次出血事件，其中2次较为严重。无显著的栓塞并发症。溶栓治疗失败未导致任何患者的缺血情况恶化。局部灌注溶栓药物是治疗闭塞性搭桥移植物的一种有用辅助方法。
