Pathophysiology of haemostasis and thrombosis vol:32 issue:5-6 pages:299-302
Regional thrombolytic therapy for arterial occlusion of the limbs uses several catheter-guided techniques and various infusion methods and therapeutic schemes. There is no definite proof of superiority of any agent in terms of efficacy and safety. A meta-analysis of randomized trials comparing surgery to thrombolysis in leg ischemia shows no significant difference in major amputation and mortality between these two management options. Major bleeding is the main complication. Recent developments include the introduction of new thrombolytic agents, associated infusion of glycoprotein IIb-IIIa blockers and use of ultrasound to disrupt thrombi or facilitate thrombolysis.