Recanalization of Chronic Peripheral Arterial Occlusions Using Local Low dose Thrombolysis:in Combination with Angioplasty and Stent Implantation / 介入放射学杂志

ABSTRACT

Local low-dose thrombolysis, combined with angioplasty or stent implantation, was performed in 5 patients with chronic occlusions of iliac and femoropopliteal arteries. The obstructed segments were found in the external iliac artery (n=2), common iliac and external artery (n=1), femoral artery (n=1), popliteal artery (n=1) and femoropopliteal artery (n=1). The occluded length ranged from 8～25 (mean, 15.3)cm. The estimated duration of occlusions were from 1～24(mean, 9.4) months. Local thrombolysis was performed by using urokinase 56, 000 IU/h, accompanied by heparin treatment (1,000 IU/h) in all patients. The infusion time ranged from 5.5～58(mean, 26) hours. PTA (n=3) and intravascular stent placement (n=1) were immediately performed after thrombolysis. The initial success rate was 100%. Follow-up lasted 2～9 months (mean 5.3 months). This approach was even succesful in a patient with occluded duration up to 2 years. This therapy represents a true altermative to vascular surgery and as first-choice treatment for segmental peripheral occlusions. Thrombolytic procedure dose, interventional indications, other factors and long-term effects were discussed.