Thrombolysis for acute arterial occlusion

J Vasc Surg. 2010 Aug;52(2):512-5. doi: 10.1016/j.jvs.2010.01.080.

Abstract

Introduction: Acute leg ischemia is one of the most challenging and dangerous conditions in vascular surgical practice and carries a high risk of amputation and death when left untreated. This article provides an overview of the currently held opinions on the role of catheter-based thrombolytic therapy in patients with acute leg ischemia.

Methods: A systematic review of literature from 1980 to 2009 was performed. The literature analyzed included randomized trials, large single-center case series, and review articles.

Results: Three large randomized trials and 14 review articles were identified. Pharmacologic aspects and the results of thrombolytic therapy, as well as indications, contraindications, and complications are described.

Conclusions: Catheter-directed thrombolysis can be considered a complementary and not a competing technology with surgical or percutaneous revascularization, with an acceptably low complication rate.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Acute Disease
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / drug therapy*
  • Arterial Occlusive Diseases / physiopathology
  • Evidence-Based Medicine
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Ischemia / drug therapy*
  • Ischemia / etiology
  • Ischemia / physiopathology
  • Lower Extremity / blood supply*
  • Odds Ratio
  • Patient Selection
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Thrombolytic Therapy* / adverse effects
  • Treatment Outcome
  • Vascular Patency

Substances

  • Fibrinolytic Agents