The role of thrombolysis in the management of thromboembolic disorders: a four-year review.
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.
Sylvester
P A
PA
Department of Surgery, Bristol Royal Infirmary, U.K.
Davies
A H
AH
Holgate
A
A
Nathanson
E
E
Murphy
P
P
Baird
R N
RN
Lamont
P M
PM
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