value of completion intraarterial thrombolysis in the management of delayed lower limb embolism

Seventeen cases of delayed acute embolic ischemia of the lower limb were managed in our center. They received intraarterial thrombolysis because of residual thrombus or persistent ischemia or both after catheter embolectomy [Group I patients]. This group of patients was compared retrospectively to another similar group of 13 patients of delayed acute embolic ischemia who were managed by transfemoral embolectomy followed by popliteal exposure due to the presence of persistent ischemia or residual thrombus that could not be extracted through the transfemoral route [Group II patients]. The results of the two groups were compared as regards the outcome and complication of each procedure. The limb salvage rate was 81.2% in group I patients with thrombolytic therapy, with 17.6% bleeding complications, as compared to 77% in group II patients with 7.6% bleeding complications. Intraoperative intraarterial completion thrombolysis is effective and safe adjunct to catheter embolectomy in the inalulgement of delayed arterial embolism