Detection of left heart thrombus by echocardiography is not essential before peripheral arterial thrombolysis.
Left heart thrombus has been regarded as a contraindication to thrombolysis. In this prospective study the role of echocardiography before thrombolysis in the cardiac assessment of 51 patients undergoing thrombolysis for a peripheral arterial occlusion was evaluated. Ten patients with positive echocardiograms were identified. Echocardiography contributed to the diagnosis of embolus in one patient. All eight patients with embolic arterial occlusions were successfully recanalized, comparing favourably with a success rate of 58% in patients with thrombotic occlusions. There were no embolic complications during thrombolytic treatment or in the subsequent 30 days. We conclude that thrombolysis can be performed safely despite the presence of left heart thrombus.
Lonsdale
R J
RJ
Department of Vascular Surgery, University Hospital, Nottingham, UK.
Berridge
D C
DC
Makin
G S
GS
Hopkinson
B R
BR
Wenham
P W
PW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000075202:Contraindications; D004452:Echocardiography / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015912:Thrombolytic Therapy / Q000592:standards*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome