Results of thrombolysis in the treatment of arterial ischemia of the limbs according to mode of administration.
After reviewing the principles, results and complications of thrombolytic therapy with "classical" agents (Streptokinase and Urokinase) used via intravenous, intraarterial route, or intraoperatively, and with more "modern" agents (APSAC, scuPA, tPA), we discuss the future of thrombolysis in the treatment of arterial ischemia of the limbs. Several items need to be clarified: --indication of thrombolysis among other treatments, mainly surgery, of arterial ischemia depends on the clinical staging of ischemia, its causes and the site of arterial obstruction; --method of delivery of the thrombolytic agent must provide the highest local concentration and the lowest systemic side effects; --efficacy of each thrombolytic agent must be analyzed when used in peripheral arterial ischemia, but also in other diseases such as myocardial infarction.
Marzelle
J
J
Service de Chirurgie Vasculaire, Hopital Saint-Joseph, Paris.
Combe
S
S
Gigou
F
F
Samama
M
M
D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*
D005343:Fibrinolytic Agents