Staxrud L E, Schilvold A, Ly B, Rosén L, Line P D, Kroese A, Jørgensen J J
Karkirurgisk avdeling, Aker sykehus, Oslo.
Tidsskr Nor Laegeforen. 1996 Oct 20;116(25):2996-9.
Local intra-arterial low-dose thrombolysis has become a therapeutic alternative for acute and subacute occlusion of vascular grafts and native vessels in the lower limbs. The series comprises 31 patients treated with Streptokinase as thrombolytic agent. Complete primary thrombolysis was achieved in 20 patients, whereas in 11 patients the outcome was only partially successful or a failure. Vascular stenoses were considered to precipitate thrombosis in 18 cases, and prompted percutaneous transluminal angioplasty after thrombolysis. Two-year patency was 48% (30-66%) in the total series and 74% (56-92%) among the patients with successful primary thrombolysis. There were no major complications. Five patients sustained local inguinal haemorrhage, of whom three required surgical revision. Local intra-arterial thrombolysis is an elaborate procedure associated with potential hazardous complications. It should be carried out in institutions with radiological and vascular surgical expertise.
局部动脉内低剂量溶栓已成为治疗下肢血管移植物和天然血管急性和亚急性闭塞的一种替代疗法。该系列包括31例接受链激酶作为溶栓剂治疗的患者。20例患者实现了完全原发性溶栓，而11例患者的结果仅部分成功或失败。18例病例中血管狭窄被认为是血栓形成的诱因，并在溶栓后促使进行经皮腔内血管成形术。整个系列的两年通畅率为48%（30%-66%），原发性溶栓成功的患者中为74%（56%-92%）。无重大并发症。5例患者发生局部腹股沟出血，其中3例需要手术修复。局部动脉内溶栓是一种复杂的操作，伴有潜在的危险并发症。应在具备放射学和血管外科专业知识的机构中进行。
