Comparison of thrombolytic therapy of lower-extremity acute, subacute, and chronic arterial occlusions

Michael H. Wholey, Manuel A. Maynar, Mark H. Wholey, Juan M. Pulido-Duque, Ricardo Reyes, Chester R. Jarmolowski, Wilfrido R. Castaneda

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

Our purpose was to study the effectiveness of thrombolytic therapy in treating acute, subacute, and chronic arterial occlusions in a multicenter retrospective study. Intraarterial urokinase infusion was performed in 235 patients for occluded native arteries. There were 70 (30%) with acute and 26 (5%) with subacute occlusions, and 141 (59%) with chronic symptoms for longer than 3 mo. Complete thrombolysis was achieved in 60 (86%) of the acute, 20 (77%) of the subacute, and 106 (75%) of the chronic occlusions. Adjunctive interventional procedures were performed as needed. Long-term follow-up revealed a primary patency of 87%, 85%, and 76% for the acute, subacute, and chronic occlusion groups, respectively. We conclude that the rate of complete thrombolysis of chronic occlusions proved slightly more efficient for acute and virtually the same for subacute occlusions. Long-term follow-up demonstrated a higher failure rate with chronic than with acute occlusions, probably due to worsened peripheral vascular runoff.

Original languageEnglish (US)
Pages (from-to)159-169
Number of pages11
JournalCatheterization and Cardiovascular Diagnosis
Volume44
Issue number2
DOIs
StatePublished - Jun 1998

Keywords

  • Arteries
  • Extremities
  • Thrombolysis
  • Transluminal angioplasty
  • Urokinase

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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