Wholey M H, Maynar M A, Wholey M H, Pulido-Duque J M, Reyes R, Jarmolowski C R, Castaneda W R
Department of Interventional Radiology, Louisiana State University School of Medicine, New Orleans, USA.
Cathet Cardiovasc Diagn. 1998 Jun;44(2):159-69. doi: 10.1002/(sici)1097-0304(199806)44:2<159::aid-ccd8>3.0.co;2-5.
Our purpose was to study the effectiveness of thrombolytic therapy in treating acute, subacute, and chronic arterial occlusions in a multicenter retrospective study. Intraarterial urokinase infusion was performed in 235 patients for occluded native arteries. There were 70 (30%) with acute and 26 (5%) with subacute occlusions, and 141 (59%) with chronic symptoms for longer than 3 mo. Complete thrombolysis was achieved in 60 (86%) of the acute, 20 (77%) of the subacute, and 106 (75%) of the chronic occlusions. Adjunctive interventional procedures were performed as needed. Long-term follow-up revealed a primary patency of 87%, 85%, and 76% for the acute, subacute, and chronic occlusion groups, respectively. We conclude that the rate of complete thrombolysis of chronic occlusions proved slightly more efficient for acute and virtually the same for subacute occlusions. Long-term follow-up demonstrated a higher failure rate with chronic than with acute occlusions, probably due to worsened peripheral vascular runoff.
我们的目的是在一项多中心回顾性研究中，研究溶栓疗法治疗急性、亚急性和慢性动脉闭塞的有效性。对235例天然动脉闭塞患者进行了动脉内尿激酶输注。其中70例（30%）为急性闭塞，26例（5%）为亚急性闭塞，141例（59%）有超过3个月的慢性症状。急性闭塞患者中有60例（86%）、亚急性闭塞患者中有20例（77%）、慢性闭塞患者中有106例（75%）实现了完全溶栓。根据需要进行了辅助介入手术。长期随访显示，急性、亚急性和慢性闭塞组的一期通畅率分别为87%、85%和76%。我们得出结论，慢性闭塞的完全溶栓率在急性闭塞时略高，在亚急性闭塞时几乎相同。长期随访表明，慢性闭塞的失败率高于急性闭塞，这可能是由于外周血管血流情况恶化所致。
