Author/Editor		Poredoš, P; Videčnik, V
Title		Factors affecting the initial and long term efficacy of intraarterial thrombolysis
Type		članek
Source		In: Bastounis EA, editor. 13th congress of the European chapter of the international union of angiology; 1999 May 26-30; Rhodes, Greece. Bologna: Monduzzi editore,
Publication year		1999
Volume		str. 103-8
Language		eng
Abstract		Local thrombolytic treatment is an effective alternative for treatment of arterial occlusions. It leads to considerable and long-term improvement in most treated patients. The most important advantage of local thrombolytic treatment is its minimal invasivness. Therefore it is accessible to patients with contraindication for more invasive procedures. The recanalization rate is influenced by the length and location of the occlusion, but the duration of the arterial disease (up to 3 months), diabetes mellitus and the cause of the arterial occlusion has no influence on therapeutic success. Reocclusion rates are predominantly related to the štatus of out- flow shank arteries and to the presence of diabetes mellitus. Concomitant intraarterial application of heparin prevents ascending thrombosis at the catheter and improves the clinical outcome. Apptication of a tocal low dose of heparin does not cause systemic changes of blood coagulation and therefore has advantages over systemic application. Prior enrichment of the thrombus with exogenous plasminogen does not significantly increase the recanalization rate but shortens the duration of treatment up to reperfusion. Successful treatment is associated with some systemic lytic effects (shorter ECLT, decrease of plasminogen concentration). This could imply that some systemic effects are needed for thrombolytic success and that also by local application of the drug, additional delivery of plasminogen activators is obtained during recirculation of the drug.
Descriptors		ARTERIAL OCCLUSIVE DISEASES THROMBOLYTIC THERAPY HEPARIN STREPTOKINASE DIABETES MELLITUS INFUSIONS, INTRA-ARTERIAL FEMORAL ARTERY TREATMENT OUTCOME