Author/Editor		Poredoš, P; Keber, D; Videčnik, V
Title		Late results of local thrombolytic treatment of peripheral arterial occlusions
Type		članek
Source		Angiology
Vol. and No.		Letnik 40, št. 11
Publication year		1989
Volume		str. 941-7
Language		eng
Abstract		One hundred thirty-four patients, in whom acute and subacute arterial occlusions of lower limbs were treated with low dose intraarterial streptokinase, were observed for periods of up to five years. Primary recanalization of occluded vessels was achieved in 66 patients, but in the remaining 68 patients recanalization was not observed. In 45 percent of the patients with successful thrombolytic treatment, percutaneous dilatation (PTA) of remnant stenosis was performed. In patients with successful recanalization the reocclusion rate was greatest in the first year (17.4 percent); the first two weeks after therapy were most critical in this respect. The reocclusion rate during the succeeding years ranged from 4 percent to 9 percent per year. The cumulative patency rate after five years was 63.4 percent. Late results were better in patients in whom more proximal vascular segments were affected. The preservation of vessel patency was highly dependent on the severity and extent of the previous atherosclerotic process and especially on the state of peripheral (runoff) arteries. Presence of diabetes mellitus increased the reocclusion rate of recanalized vessels. Of the patients with unsuccessful recanalization, only 5 reported some symptomatic improvement during the observation period, 39 (57 percent) needed immediate amputation, and an additional 8 (4.7 percent) were amputated later on. Considering the fact that all patients were previously refused for bypass surgery owing to unsuitable runoff vessels or bad general condition, the long-term results were surprisingly good, suggesting that thrombolytic treatment, combined in remnant stenosis with PTA, was an efficient method in patients with acute or subacute arterial occlusions.
Descriptors		ARTERIAL OCCLUSIVE DISEASES STREPTOKINASE ADULT AGED AGED, 80 AND OVER ANGIOGRAPHY ARTERIAL OCCLUSIVE DISEASES LEG MIDDLE AGE RECURRENCE TIME FACTORS VASCULAR PATENCY