Results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg

Eur J Vasc Endovasc Surg. 2011 Jan;41(1):91-6. doi: 10.1016/j.ejvs.2010.09.009. Epub 2010 Nov 5.

Abstract

Objectives: To observe immediate and late results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg.

Design, material and methods: A total of 212 patients treated with Actilyse® at the University Hospital of North Norway because of acute arterial ischaemia of the leg during the period 01 January 2000-30 June 2006 were analysed retrospectively.

Results: The radiologic outcome was judged to be successful in 101 (48%), adequate in 80 (38%) and failed in 31 (14%). At 1-year follow-up, 158 (75%) were alive without amputation, 14 (7%) were alive with amputation, 20 (9%) were dead without amputation and 20 (9%) were dead with amputation. Altogether, 34 (16%) were amputated and 40 (19%) were dead after 1 year. After an average observation period of 3.25 years, 111 (52%) were alive without amputation, 16 (8%) were alive with amputation, 60 (28%) were dead without amputation and 25 (12%) were dead with amputation. A total of 41 (19%) were amputated and 85 (40%) were dead. Fifty complications were registered; 30 (14%) patients had a compartment syndrome, eight (4%) had cerebral stroke and 12 (6%) had a myocardial infarction.

Conclusions: The results are at least as good as historic controls and similar to international series. Especially, it appears as though the long-term results are somewhat better. The complication rate and morbidity are less than in surgery alone.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Arterial Occlusive Diseases / etiology
  • Arterial Occlusive Diseases / therapy
  • Catheterization*
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Heparin / administration & dosage
  • Humans
  • Ischemia / drug therapy*
  • Ischemia / etiology
  • Ischemia / mortality
  • Leg / blood supply*
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Retrospective Studies
  • Stroke / epidemiology
  • Thromboembolism / complications
  • Thromboembolism / therapy
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / administration & dosage

Substances

  • Fibrinolytic Agents
  • Heparin
  • Tissue Plasminogen Activator