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When is Thrombolysis for Acute Lower Limb Ischemia Worthwhile?

Författare:
Publiceringsår: 2009
Språk: Engelska
Sidor: 206-212
Publikation/Tidskrift/Serie: European Journal Of Vascular And Endovascular Surgery
Volym: 37
Nummer: 2
Dokumenttyp: Artikel
Förlag: W B Saunders Co Ltd

Sammanfattning

Objectives: To find variables associated with outcome following thrombolytic treatment for acute lower limb ischemia. Design: Re-analysis of a prospective multicentre study. Material and methods: One hundred and twenty-one patients with acute lower limb ischemia previously included in a randomised study comparing high- with low-dose thrombolysis were re-analysed ignoring the mode of lytic treatment. All possibly predictive variables were subjected to multivariate analyses to find associations with outcome. Results: Previous successful thrombolysis, ankle-brachial index over 0.33, absence of motor dysfunction, presence of cardiac arrhythmia, and lysis of a vascular graft were all associated with successful thrombolysis (p = 0.003). Previous thrombolysis, age less than 70 years, and ankle-brachial index over 0.33 were all perfect predictors of absence of life-threatening complications or death. Successful lysis, age < 70, and lysis of a native artery as opposed to a vascular graft were all associated with clinical success (preserved patency, limb, and life) after one year (p = 0.002). Conclusions: Previous thrombolysis, age under 70 years, and non-severe ischemia predict successful thrombolysis free from severe complications. Successful thrombolysis is strongly predictive of amputation-free survival with vascular patency for at least one year. Occluded grafts could often be reopened, but long-term outcome is better after thrombolysis of native arteries. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Disputation

Nyckelord

  • Medicine and Health Sciences
  • Ischemia
  • Lower extremity
  • Arterial occlusive disease
  • Thromboembolism
  • Thrombolytic therapy

Övriga

Published
Yes
  • ISSN: 1078-5884

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