title: Thrombolysis in high risk patients.
abstract: The advent of intra-arterially administered thrombolytic agents of minimal antigenicity, together with small gauge good torque control catheters, enables thrombolysis to be used in patients that may previously have been deemed unsuitable for thrombolytic therapy. Thrombolysis may be used even in the presence of factors formerly and empirically considered to be contra-indications. The continued use of thrombolytic agent may also be warranted despite iatrogenic complications such as vessel wall perforation, particularly if the alternative is major amputation. We report on a series of eight patients in whom intra-arterial tissue plasminogen activator was used despite either recent vascular surgery, or iatrogenic vessel perforation. Suggestions for the use of thrombolysis in high risk patients and following iatrogenic complications are discussed.
authors.affiliation: Department of Radiology, Royal Free Hospital, London.
authors.forename: J
authors.initials: J
authors.lastname: McCall
authors.forename: F V
authors.initials: FV
authors.lastname: Gleeson
authors.forename: G
authors.initials: G
authors.lastname: McGann
authors.forename: K
authors.initials: K
authors.lastname: Dawson
authors.forename: A D
authors.initials: AD
authors.lastname: Platts
authors.forename: G
authors.initials: G
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000453:epidemiology; D011183:Postoperative Complications / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator