ArticleThe British journal of surgery2014
Outcome and complications after intra-arterial thrombolysis for lower limb ischaemia with or without continuous heparin infusion.
Article in The British journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- CIRSE Standards of Practice for the Provision of Emergency IR Care on a 24/7 Basis.Cardiovascular and interventional radiology · 2026Guideline
- Open or endovascular revascularization in the treatment of acute lower limb ischaemia.The British journal of surgery · 2018Trial
- Catheter-Directed Arterial Thrombolysis with a Low-Dose Recombinant Tissue Plasminogen Activator Regimen for Acute Lower Limb Ischemia-Results of the First Regional Registry of Acute Limb Ischemia in Romania.Life (Basel, Switzerland) · 2024Article
- Catheter-Directed Thrombolysis in the Management of Thrombotic Peripheral Artery Occlusions-Acute and Mid-Term Clinical Outcomes.Journal of clinical medicine · 2024Article
- [Ischemia-related compartment syndromes in vascular surgery].Chirurgie (Heidelberg, Germany) · 2024Review
- Bypass Patency and Amputation-Free Survival after Popliteal Aneurysm Exclusion Significantly Depends on Patient Age and Medical Complications: A Detailed Dual-Center Analysis of 395 Consecutive Elective and Emergency Procedures.Journal of clinical medicine · 2024Article
- Predictors of bleeding complications during catHeter-dirEcted thrombolysis for peripheral arterial occlusions (POCHET).PloS one · 2024Article
- A Very Rare Cause of Thrombotic Peripheral Occlusion.The International journal of angiology : official publication of the International College of Angiology, Inc · 2023Article
- Thoracic Endovascular Aortic Repair (TEVAR) First in Patients with Lower Limb Ischemia in Complicated Type B Aortic Dissection: Clinical Outcome and Morphology.Journal of clinical medicine · 2022Article
- In-Hospital Outcomes after Endovascular Therapy for Acute Limb Ischemia: A Report from a Japanese Nationwide Registry [J-EVT Registry].Journal of atherosclerosis and thrombosis · 2021Article
- The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis.Scientific reports · 2021Article
- Catheter-directed intra-arterial thrombolysis for lower extremity arterial occlusions.Anatolian journal of cardiology · 2019Review
- Acute Limb Ischemia Therapies: When and How to Treat Endovascularly.Seminars in interventional radiology · 2018Review
- Outcome of intra-arterial thrombolysis in patients with diabetes and acute lower limb ischemia: a propensity score adjusted analysis.Journal of thrombosis and thrombolysis · 2017Article
- Effects of Intravenous and Catheter Directed Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator (Alteplase) in Non-Traumatic Acute Limb Ischemia; A Randomized Double-Blind Clinical Trial.Bulletin of emergency and trauma · 2015Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThrombolysis is a common treatment for acute leg ischaemia. The purpose of this study was to evaluate different thrombolytic treatment strategies, and risk factors for complications.
methodsThis was a retrospective analysis of prospective databases from two vascular centres. One centre used a higher dose of heparin and recombinant tissue plasminogen activator (rtPA).
resultsSome 749 procedures in 644 patients of median age 73 years were studied; 353 (47·1 per cent) of the procedures were done in women. The aetiology of ischaemia was graft occlusion in 38·8 per cent, acute arterial thrombosis in 32·2 per cent, embolus in 22·3 per cent and popliteal aneurysm in 6·7 per cent. Concomitant heparin infusion was used in 63·2 per cent. The mean dose of rtPA administered was 21·0 mg, with a mean duration of 25·2 h. Technical success was achieved in 80·2 per cent. Major amputation and death within 30 days occurred in 13·1 and 4·4 per cent respectively. Bleeding complications occurred in 227 treatments (30·3 per cent). Blood transfusion was needed in 104 (13·9 per cent). Three patients (0·4 per cent of procedures) had intracranial bleeding; all were fatal. Amputation-free survival was 83·6 per cent at 30 days at both centres. In multivariable analysis, preoperative severe ischaemia with motor deficit was the only independent risk factor for major bleeding (odds ratio (OR) 2·98; P <0·001). Independent risk factors for fasciotomy were severe ischaemia (OR 2·94) and centre (OR 6·50). Embolic occlusion was protective for major amputation at less than 30 days (OR 0·30; P = 0·003). Independent risk factors for death within 30 days were cerebrovascular disease (OR 3·82) and renal insufficiency (OR 3·86).
conclusionBoth treatment strategies were successful in achieving revascularization with acceptable complication rates. Continuous heparin infusion during intra-arterial thrombolysis appeared to offer no advantage.
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