[Therapeutic efficiency of of pulsed spray lysis in peripheral arterial occlusions].
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.
Roeren
T
T
Abteilung Radiodiagnostik, Radiologische Universitätsklinik Heidelberg.
Lachenicht
B
B
Düx
M
M
Hoffmann
V
V
Richter
G
G
Kauffmann
G
G
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
D005343:Fibrinolytic Agents
Therapeutische Effizienz der gepulsten Sprühlyse bei peripheren arteriellen Verschlüssen.