Thrombolysis in Acute Lower Limb Ischemia: Review of the Current Literature

Annals of Vascular Surgery
Panagiotis G TheodoridisKonstantinos Dervisis

Abstract

Catheter-directed thrombolysis (CDT) is a therapeutic option with acceptable results in patients with acute limb ischemia (ALI) but with severe systemic or intracranial bleeding being the most significant clinical complication. The aim of the study is to collect and present direct results of CDT in patients treated for ALI. Reports on CDT treatment in ALI until December 2016 were searched in PubMed using the keywords catheter direct thrombolysis, acute lower limb ischemia, and any combination. A total of 256 clinical trials were identified. After the exclusion criteria were applied, 10 articles were selected including 1,249 patients and 1,361 lower extremities treated for ALI. Acute thrombosis of a limb artery or bypass graft was the main cause of ischemia ranging from 77.7% to 98.0%. The overall technical success rate of the applied method reached 79.3% (1,079 successful cases). Complications of any type occurred in 358 (28.7%) patients. Of them, 72 (20.1%) experienced a minor complication while 286 (79.9%) had a major life-threatening complication. The need for secondary interventions was 77.8% (935 patients). The death rate during the first month was 4.2% (56 patients), while the percentage of patients who suffered amputatio...Continue Reading

Citations

Apr 18, 2019·Vascular Specialist International·Benjamin LindCheong Jun Lee
Apr 30, 2020·Cardiology in Review·George L Hines, Helen H Liu
Feb 2, 2021·Clinical Hemorheology and Microcirculation·Wilma SchierlingKarin Pfister
Nov 24, 2020·Annals of Vascular Surgery·Matilde ZamboniPaolo Frigatti

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