Local intra-arterial thrombolysis for peripheral arterial occlusion

Abstract

Background: Local intra-arterial thrombolysis is one of the methods of treatment of acute ischaemia of extremities. Its aim is the rapid restoration of arterial patency and the reperfusion of the ischaemic extremity. It also allows diagnosis of the cause of artery or graft occlusion. Identification and description of arterial wall lesions informs decisions optimizing further therapy, either surgical or endovascular.
Material and methods: From January to December 2003, 5 patients with femoro-popliteal occlusions were treated with local intra-arterial thrombolysis. All patients underwent a colour Doppler examination followed by angiography, which confirmed the diagnosis. A catheter was introduced through a femoral artery puncture and its tip was localized in the region of the artery occlusion. All patients obtained streptokinase. The progress of thrombolysis was monitored by repeated angiography and treatment was continued for up to 6 hours after the radiographically confirmed restoration of patency of the vessel.
Results: In all 5 treated patients we restored patency of the previously occluded artery and obtained complete remission of symptoms of lower limb ischaemia.
Conclusions: Local intra-arterial thrombolysis is a safe and effective method of treating lower limb ischaemia in selected patients. It allows for a decrease in the total dose of the thrombolytic agent and can be a good alternative to surgical procedure.