Colour duplex sonography-guided local lysis of occlusions in the femoro-popliteal region.
BACKGROUND
To evaluate colour duplex sonographic guidance of local lysis of occlusions in the femoropopliteal region.


METHODS
Thirteen consecutive patients (8 female, mean age 67) with peripheral artery disease with acute and subacute occlusions in the superficial femoral or popliteal artery were included in this study. The lesions were identified by colour duplex ultrasound (Acuson 128 XP/10) After anterograde puncture the guidewire was advanced through the arterial lesions under B-mode image control. The Mewissen Infusion Catheter and a Katzen infusion wire were then accurately positioned within the lesion under B-mode image control. The fibrinolytic drugs were then inserted into the occlusions, initially 2.5 mg rt-PA as a bolus followed by Urokinase (50,000 IU/h) for 24 hours. After control duplex sonography (over 24 hours) the additional angioplasty was performed either under fluoroscopic or exclusively under ultrasound guidance.


RESULTS
Eleven of 13 patients with occlusions in the femoro-popliteal region were partially recanalised after ultrasound guided local lysis and after the additional angioplasties (nine under fluoroscopic and three under ultrasound guidance) the arteries were completely recanalised.


CONCLUSIONS
Our data show that not only is the positioning of the catheter and the guidewire for local lysis exclusively under colour duplex guidance possible, but also the surveillance of the local lysis and the additional angioplasty. In the case of any complications, however, easy access to angiography should be possible.
Katzenschlager
R
R
Department of Angiology, University of Vienna, Austria.
Ahmadi
A
A
Atteneder
M
M
Ugurluoglu
A
A
Koppensteiner
R
R
Minar
E
E
Ehringer
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D003131:Combined Modality Therapy; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000187:drug effects*; D015912:Thrombolytic Therapy; D018615:Ultrasonography, Doppler, Color; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects
D014568:Urokinase-Type Plasminogen Activator