Thrombolysis for acute arterial occlusion.
BACKGROUND
Acute leg ischemia is one of the most challenging and dangerous conditions in vascular surgical practice and carries a high risk of amputation and death when left untreated. This article provides an overview of the currently held opinions on the role of catheter-based thrombolytic therapy in patients with acute leg ischemia.


METHODS
A systematic review of literature from 1980 to 2009 was performed. The literature analyzed included randomized trials, large single-center case series, and review articles.


RESULTS
Three large randomized trials and 14 review articles were identified. Pharmacologic aspects and the results of thrombolytic therapy, as well as indications, contraindications, and complications are described.


CONCLUSIONS
Catheter-directed thrombolysis can be considered a complementary and not a competing technology with surgical or percutaneous revascularization, with an acceptably low complication rate.
van den Berg
Jos C
JC
Service of Interventional Radiology, Ospedale Regionale di Lugano, sede Civico, Lugano, Switzerland. jos.vandenberg@eoc.ch
D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D035002:Lower Extremity / Q000098:blood supply*; D016017:Odds Ratio; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome; D014654:Vascular Patency
D005343:Fibrinolytic Agents