[Intra-arterial lysis therapy in acute limb ischemia. Technical possibilities and limits of indication].
Acute limb ischemia is associated with a high risk of death and loss of the extremity. To restore the blood flow, several percutaneous thrombolytic techniques were developed. To achieve a targeted thrombus infiltration, the continuous application of low-dose urokinase or recombinant tissue plasminogen activator using a specific lysis catheter with sideholes is preferable. Concerning the amputation-free survival, thrombolysis is superior to surgery for occlusions of native vessels or bypass grafts that are not older than 2 weeks. Furthermore, the percutaneous approach permits the simultaneous treatment of the underlying lesion by angioplasty or stent implantation after dissolution of the occluding thrombus. The higher risk of complications must be balanced against risks of surgery in each patient.
Bräunlich
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S
Abteilung für Klinische und Interventionelle Angiologie, Universität Leipzig-Herzzentrum, Leipzig.
Scheinert
S
S
Schmidt
A
A
Biamino
G
G
Storck
M
M
Scheinert
D
D
D000208:Acute Disease; D000792:Angiography; D000800:Angioplasty, Balloon; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D005121:Extremities / Q000098:blood supply*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D007511:Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use; D012307:Risk Factors; D015607:Stents; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator