title: [Therapeutic efficiency of of pulsed spray lysis in peripheral arterial occlusions].
abstract: OBJECTIVE
  To determine the clinical efficacy of pulse-spray thrombolysis.
  
  
  METHODS
  In a prospective trial 28 patients with acute arterial (n = 14) and bypass (n = 14) occlusions of the lower extremities were treated with pulse spray thrombolysis. 23/28 legs were at risk.
  
  
  RESULTS
  Technical and clinical success were 89% and 68% respectively. Time interval until restitution of antegrade flow was less than two hours, the median duration of the complete intervention was 17 hours. Two patients (7.1%) needed transfusions for inguinal haematomas. After six months 50% of occluded segments remained patent, secondary patency is comparable at 53%. Bypasses show significantly lower patency (p = 0.04) and higher amputation (p = 0.009) rates than native arteries. Bad run-off (< or = 1 artery patent) is a significant predictor for clinical failure and early amputation.
  
  
  CONCLUSIONS
  The distinct advantage of pulse-spray thrombolysis is fast restoration of antegrade flow and thereby effective treatment of acute ischaemia. The complication rate is low without associated mortality.
authors.affiliation: Abteilung Radiodiagnostik, Radiologische Universitätsklinik Heidelberg.
authors.forename: T
authors.initials: T
authors.lastname: Roeren
authors.forename: B
authors.initials: B
authors.lastname: Lachenicht
authors.forename: M
authors.initials: M
authors.lastname: Düx
authors.forename: V
authors.initials: V
authors.lastname: Hoffmann
authors.forename: G
authors.initials: G
authors.lastname: Richter
authors.forename: G
authors.initials: G
authors.lastname: Kauffmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002404:Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents
vernacular_title: Therapeutische Effizienz der gepulsten Sprühlyse bei peripheren arteriellen Verschlüssen.