title: Endovascular treatment of acute limb ischemia: review of current plasminogen activators and mechanical thrombectomy devices.
abstract: Acute limb ischemia occurs in 15% to 20% of patients with chronic peripheral arterial disease. Off-label use of tissue plasminogen activators is the most common approach for patients with ischemic limbs that can wait 24 to 48 hours to restore flow. In the past decade, mechanical thrombectomy devices that use aspiration, maceration, or ultrasound waves have been developed to allow more rapid restoration of flow. Combination therapy with both mechanical and pharmacologic thrombolysis has become commonplace without randomized data to support its use. This article reviews acute limb ischemia and data regarding pharmacologic and mechanical thrombolysis.
authors.affiliation: Lerner Cleveland Clinic College of Medicine at Case Western Reserve University, Desk H32, Department of Vascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. lydens@ccf.org
authors.forename: Sean P
authors.initials: SP
authors.lastname: Lyden
mesh_terms: D000208:Acute Disease; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D005121:Extremities / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D058729:Peripheral Arterial Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010960:Plasminogen Activators / Q000627:therapeutic use*; D017131:Thrombectomy / Q000295:instrumentation*; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D010960:Plasminogen Activators