title: The role of thrombolysis in the management of thromboembolic disorders: a four-year review.
abstract: OBJECTIVE
  To examine the role of thrombolysis alone, or in conjunction with surgery and angioplasty, in the treatment of thromboembolic disorders.
  
  
  METHODS
  A retrospective review of 70 patients, who received thrombolysis on 73 occasions between 1990 and 1993.
  
  
  METHODS
  Four groups were defined: (1) thrombolysis alone (40%); (2) thrombolysis followed by angioplasty (23%); (3) thrombolysis followed by surgery (13%) and (4) thrombolysis after failed angioplasty (24%).
  
  
  RESULTS
  Twenty-eight patients (40%) received thrombolysis alone of which 13 were successful. In 25 cases (36%) thrombolysis was initially successful in that it permitted further angioplasty or surgical reconstruction. This adjunctive treatment was successful in 16 cases. Overall, when used as a first-line treatment, thrombolysis was successful in 72% of cases. Success in this context includes those in which a further procedure was possible after thrombolysis. These groups included 20 occluded grafts in which thrombolysis played an important part in unblocking 13 (65%) of them. In a separate group of 17 patients (24%) thrombolysis was given after failed angioplasty and was successful on 15 (88%) occasions. Local complications occurred in 17 patients. There were three deaths. There were no intra-cerebral haemorrhages.
  
  
  CONCLUSIONS
  Thrombolysis alone can be used successfully. There is a large group in which thrombolysis can help to increase the success rate of interventional radiology.
authors.affiliation: Department of Surgery, Bristol Royal Infirmary, U.K.
authors.forename: P A
authors.initials: PA
authors.lastname: Sylvester
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
authors.forename: A
authors.initials: A
authors.lastname: Holgate
authors.forename: E
authors.initials: E
authors.lastname: Nathanson
authors.forename: P
authors.initials: P
authors.lastname: Murphy
authors.forename: R N
authors.initials: RN
authors.lastname: Baird
authors.forename: P M
authors.initials: PM
authors.lastname: Lamont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013923:Thromboembolism / Q000188:drug therapy* / Q000601:surgery; D015912:Thrombolytic Therapy / Q000009:adverse effects