[In loco fibrinolytic treatment of acute ischemia of the lower limbs].

Peripheral artery occlusion produced by thrombosis or embolus can be cured by intra-arterial low dose thrombolysis without severe hemorrhagic complications. 18 patients suffering of acute ischemia of lower limbs were treated by intra-arterial streptokinase infusion. Diagnostic angiography is performed by antegrade femoral puncture using a 5F straight catheter. The tip of the catheter is placed within the thrombus. After a bolus of 10 000 U, streptokinase is infused at the rate of 2,000 U/min. Fibrinolysis is usually achieved within 70 min with a total dose of 150,000 U. Arterial recanalization occurred in 14 patients, in 6 cases underlying stenosis was successfully treated by percutaneous transluminal angioplasty. No severe complications were encountered.