[Modified manual rt-PA pulse-spray lysis in occlusions of leg arteries and femoro-popliteal bypasses].
OBJECTIVE
The evaluation of local rt-PA pulse-spray-lysis (PSL) by the Katzen infusion wire for treatment of thrombosed leg arteries and bypass grafts.


METHODS
21 patients (mean age 64.4 years) with either occluded leg arteries (n = 19) or femorocrural bypass grafts (n = 2) were treated with PSL. Mean length of occlusion was 13.2 +/- 11.6 cm. Time of occlusion ranged from less than one week to 6 months.


RESULTS
In 71.43% (15/21) the occlusions could be successfully recanalized with PSL. The mean rt-PA dose was 10.7 +/- 4.9 mg. Remaining stenoses were handled with PTA (n = 9) and additional stent implantation (n = 3). Additional long-time-lysis with 17.5 mg rt-PA was necessary in two cases, the success rate increased to 81% (17/21). The anlde-brachial-index increased from 0.38 +/- 0.29 to 0.83 +/- 0.32 within 24 hours after intervention. In 4 cases bleeding complications occurred. 5 patients showed reocclusions during 6 months follow-up.


CONCLUSIONS
Local fibrinolysis with rt-PA in PSL technique using the Katzen infusion wire is a feasible and promising treatment of thrombosed leg arteries and grafts. Even careful and dosage-minimized rt-PA application cannot prevent bleeding complications.
Müller-Hülsbeck
S
S
Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität zu Kiel.
Schwarzenberg
H
H
Link
J
J
Walluscheck
K
K
Brossmann
J
J
Regensburger
D
D
Heller
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000188:drug therapy*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator