Thrombolytic therapy in peripheral arterial disease

Current Drug Targets. Cardiovascular & Haematological Disorders
D Giannini, A Balbarini

Abstract

The two main causes of peripheral arterial occlusion (PAO) are embolism and thrombosis. Surgical treatment of acute limb ischemia, because of related complications, has a 30-day mortality rate of 15% to 25%. Intra-arterial thrombolysis for lower extremity ischemia is a well-accepted and frequently used technique. It may offer definitive treatment without the need for major surgery in a significant series of patients with acute occlusion of a native leg artery or a by-pass graft. Thrombolysis can offer several potential advantages when compared with surgical therapy. Thrombolytic agents include streptokinase (SK), urokinase (UK), pro-UK and recombinant tissue plasminogen activators (rt-PA-Alteplase and r-PA-Reteplase). All these agents induce a systemic fibrinolytic state. Three prospective randomized trials, ROCHESTER, STILE, and TOPAS, which compared thrombolytic therapy with traditional surgical revascularization for lower limb ischemia, have recently been published. They suggest that thrombolysis, as an initial therapy, reduces the risk of subsequent surgery and improves limb salvage for patients with PAO. Using this approach, the underlying lesions can be identified and treated by transluminal balloon angioplasty or stentin...Continue Reading

Citations

Sep 13, 2011·Der Internist·C Stelzner, R Langhoff
Feb 17, 2009·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Joann Morris, Marie Neaton
May 4, 2010·Journal of Vascular Surgery·Jos C van den Berg
Oct 4, 2007·Asian Cardiovascular & Thoracic Annals·Chandra P Shrivastava, Sanjeev Devgarha
Mar 7, 2019·American Journal of Therapeutics·Valentin ChioncelCrina Sinescu
Oct 26, 2006·Critical Care Nursing Quarterly·Gail MarchigianoCarol Jo Morse
Jan 27, 2019·Journal of Vascular Surgery·Rafael de Athayde SoaresRoberto Sacilotto

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