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Title: Local thrombolysis for occluded arterial grafts: is the yield worth the effort?
Authors: Lacroix, Hendrik ×
Suy, R
Nevelsteen, André
Verheyen, L
Stockx, L
Wilms, Guy
Verhaeghe, Raymond #
Issue Date: Aug-1994
Series Title: Journal of Cardiovascular Surgery vol:35 issue:3 pages:187-91
Abstract: This study reports the results and complications of local thrombolytic therapy of 50 recently occluded grafts. These occurred in 41 patients with acute severe but still reversible ischemia. The majority were infra-inguinal synthetic grafts. Thrombolysis was induced with urokinase (n = 1), streptokinase (n = 11) or alteplase (n = 38) via an intra-arterial catheter. Complete angiographical lysis was obtained in 36 grafts (72%) and partial lysis in 6 (12%). The highest lysis rate was obtained with alteplase (32/36; 89%). Complementary endovascular and/or surgical intervention was needed in 17 patients to correct an underlying stenosis and/or to save the limb. Fifteen complications occurred (30%) of which distal embolization (n = 4) and bleeding (n = 8 of which 3 fatal) were the most frequent. Six of the bleeding episodes occurred in patients on chronic aspirin intake. The late results were poor. At six months, the primary patency of successfully lysed grafts dropped to 19% and the limb salvage rate to 64%. Thrombolytic therapy is far from the ideal management of thrombosed grafts: maintenance of restored patency is the challenge.
ISSN: 0021-9509
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Vascular Surgery
Translational MRI (+)
× corresponding author
# (joint) last author

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