Local thrombolytic treatment in acute arterial occlusions

Abstract

Developing ischemia in relation to acute arterial obstruction in extermities is a notable condition that causes loss of extermities at some times and the patients rarely. Althought surgical embolectomy is the first choice in treatment, it may be unsuccessful specially when a chronic back ground exists. Revealing the effectivity of local thrombolytic therapy in compare and as an alternative to surgical treatment of acute arterial occlusion is the goal of this study. During October 1999 till November 2001 from patients that come to Cardiovascular Surgery Clinic or Emergency Polyclinic of our hospital with complaining of pain, coldness, cyanosis and disfunction in extremities. 15 men and 7 women, totally 22 cases underwent to the local thrombolytic theraphy with rt-PA. The patients' age were between 38-75 averagely 62. Arrival to the hospital of the patients is not earlier than 4 hours and not later than 8 days averagely 48 hours after arterial occlusion. Thrombotic occlusion in 7 patients and embolic occlusion in 15 patients were spotted. Thrombolytic treatment were successful in 12 of patients with embolic occlussion and 4 of patients with thrombotic occlusion, totally in 72.72% of patients. Ischemic period was between 4 hours till 6 days averagely 36 hours in curred group. Surgical embolectomy was applied in 6 patients that thrombolytic agents were not successful. They would come to the hospital for treatment between 24 hours till 8 days averagely 52 hours after occlussion. 3 of them died in the back ground of heart failure and amputation performed in 4 of them. Because of less hospitalization period and lower amputation rate with local thrombolytic therapy, specially in patient with high general anesthesia risks, is a preferable method.