Thrombolysis in peripheral arterial graft occlusion.
Acute thrombosis of arterial bypass grafts in the lower extremities poses a significant risk for limb loss. Graft salvage in patients affected by this complication remains a challenge. The vascular surgeon must consider the spectrum of treatment options (thrombolysis, thrombectomy, graft replacement) in managing acute graft thrombosis. Oral anticoagulants should be considered in patients with low-flow polytetrafluoroethylene (PTFE) grafts and after successful thrombolysis, with or without revision. The role of thrombolytic therapy for occluded vein grafts is less clear, but successful lysis is likely in patients who present within 48 hours of graft thrombosis and the etiology includes a correctable graft stenosis.
Bandyk
D F
DF
Department of Surgery, University of South Florida College of Medicine, Tampa.
D000208:Acute Disease; D000465:Algorithms; D000792:Angiography; D017130:Angioplasty; D000925:Anticoagulants / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000145:classification / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D002985:Clinical Protocols; D006083:Graft Occlusion, Vascular / Q000145:classification / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007866:Leg / Q000098:blood supply*; D011138:Polytetrafluoroethylene; D012086:Reoperation; D016879:Salvage Therapy / Q000379:methods; D012501:Saphenous Vein; D013300:Streptokinase / Q000627:therapeutic use*; D017131:Thrombectomy; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D000925:Anticoagulants; D011138:Polytetrafluoroethylene; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator