[Effectiveness of locoregional rt-PA lysis in acute leg and arm vein thrombosis].
39 patients suffering from a thrombosis of the peripheral venous system were treated with a loco-regional lysis, using rt-PA. Two cycles of 40 mg rt-PA a day were applicated by means of a special drainage-management, using perforans veins. During lytic therapy, 20,000 to 30,000 IE of unfractionized heparin were additionally administered. Laboratory work including aPTT and fibrinogen measurement was performed every 8 hours. Additionally a phlebography was performed after 24 hours. Patients received an anticoagulative therapy using sintrom or marcumar the following 3 months. We obtained a successful thrombolysis without any major complications in 90%. Minor complications included 3 peripheral pulmonary embolisms. Duplex sonographic and plethysmographic follow up was performed in 25 patients one year after operation. In two patients with ankle edema insufficient valves at the popliteal vein were found with both diagnostic modalities. 23 patients showed no signs of insufficient valves neither clinically nor at duplex sonography and plethysmography. The locoregional lysis appears to be an effective method for the treatment of acute peripheral vein thrombosis.
Perkmann
R
R
Klinische Abteilung für Gefässchirurgie, Universitätsklinik für Chirurgie, Innsbruck. Reinhold.Perkmann@uibk.ac.at
Neuhauser
B
B
Bodner
G
G
Tauscher
T
T
Fraedrich
G
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*
D010959:Tissue Plasminogen Activator