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When is Thrombolysis for Acute Lower Limb Ischemia Worthwhile?

På svenska

Author

  • G. Plate
  • S Oredsson
  • Jan Lanke

Summary, in English

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.

Publishing year

2009

Language

English

Pages

206-212

Publication/Series

European Journal of Vascular and Endovascular Surgery

Volume

37

Issue

2

Document type

Journal article

Publisher

Elsevier

Topic

  • Surgery

Keywords

  • Ischemia
  • Lower extremity
  • Arterial occlusive disease
  • Thromboembolism
  • Thrombolytic therapy

Status

Published

ISBN/ISSN/Other

  • ISSN: 1532-2165