INTRAOPERATIVE CATHETER THROMBOLYSIS AS AN ADJUNCT TO SURGICAL REVASCULARIZATION FOR INFRAINGUINAL LIMB-THREATENING ISCHEMIA

被引：10

作者：

KNAUS, J ^{[1
]}

RIS, HB ^{[1
]}

DO, D ^{[1
]}

STIRNEMANN, P ^{[1
]}

机构：

[1] UNIV BERN,INSELSPITAL,DEPT THORAC & CARDIOVASC SURG,CH-3010 BERN,SWITZERLAND

来源：

EUROPEAN JOURNAL OF VASCULAR SURGERY | 1993年 / 7卷 / 05期

关键词：

INTRAOPERATIVE THROMBOLYSIS; ACUTE LEG ISCHEMIA; UROKINASE;

D O I：

10.1016/S0950-821X(05)80361-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The objective of this study was to assess the benefits of intraoperative thrombolysis (IOL) on patients with acute leg ischaemia. This study was conducted in the Department of Cardiovascular Surgery, Inselspital, Berne, Switzerland. IOL was prospectively assessed in 25 patients with infrainguinal limb-threatening ischaemia due to acute thrombosis of atherosclerotic lesions and aneurysms (44%), occluded grafts (32%), arterial injuries (12%), delayed embolism (8%) and trash foot (8%). Three hundred and seventy-five thousand units of urokinase were delivered over 30 min with inflow occlusion to the profunda femoral artery in 8%, to the calf arteries via exposed trifurcation in 88% and to the pedal arch via exposed posterior tibial artery at the ankle in 8% of the patients. This was followed by graft thrombectomy in 24%, femoropopliteal bypass in 60%, intraoperative percutaneous transluminal angioplasty in 12% and vein patch angioplasty in 16%. Chief outcome measures were: postoperative morbidity; mortality; patency and limb salvage up to a maximum of 2 years. Postoperative bleeding complications occurred in two patients (8%) and consisted of two wound haematomas. Four patients died within 30 days after IOL, but no death could be attributed to IOL. All remaining patients were followed with a mean follow-up time of 10.9 months. The patency and limb salvage rate remained stable at 71 and 86% after 6 and 2 months, respectively. Conclusions were that IOL followed by surgical inflow restoration is a straightforward procedure for limb-threatening ischaemia with rewarding results regarding side effects, patency and limb salvage. © 1993 Grune & Stratton Ltd.

引用

页码：507 / 512

页数：6

共 17 条

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