[Local fibrinolytic therapy of arterial occlusions of the lower extremity: initial success and clinical outcome].
METHODS
The efficiency of local fibrinolysis therapy in patients with chronic and acute peripheral arterial occlusions of the lower extremities has been investigated.


METHODS
A total of 33 patients were examined following a local fibrinolysis therapy (in 14 cases with supplementary percutaneous transluminal angioplasty) for chronic or acute peripheral arterial occlusion of the lower extremities. The success of the intervention was first evaluated by angiography and then by subsequent controls by means of treadmill ergometry.


RESULTS
A primary intervention success was achieved in 75.8% (25 of 33 patients) of the cases. In 18.2% (6 of 33 patients) a vascular surgical operation was required within 30 days of the intervention (5 therapy failures, 1 complication of the intervention). In two further patients, vascular surgery was necessary after five or six months. In 22 of the 25 successfully treated patients (92%), the Fontaine stage was reduced by at least one step after an average of 7.6 (range: 1 to 30) months.


CONCLUSIONS
Local lysis with or without PTA represents an effective alternative therapy to vascular surgery for the treatment of peripheral arterial occlusions in not immediately endangered lower extremities. On the basis of our results and a survey of the literature, an aid for selecting therapeutic measures for patients with arterial occlusion of the extremities is presented.
Müller-Lung
U
U
Institut and Poliklinik für Radiologische Diagnostik, Universität zu Köln.
Heindel
W
W
Gawenda
M
M
Lackner
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D014568:Urokinase-Type Plasminogen Activator
Die lokale Fibrinolysetherapie bei arteriellen Verschlüssen der unteren Extremität: Initialer Erfolg und klinischer Verlauf.