Intra-arterial streptokinase infusion in acute lower limb ischaemia
- 1 June 1991
- journal article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 78 (6), 732-734
- https://doi.org/10.1002/bjs.1800780630
Abstract
Between 1986 and 1988, 38 patients (29 men and nine women), median age 65 years (range 38‐85 years), underwent local intra‐arterial streptokinase therapy for acute lower limb ischaemia. Three patient groups were identified: 15 with acute on chronic ischaemia (group 1), 12 postangioplasty (group 2) and 11 postfemorodistal bypass (group 3). Distal arteriographic run‐off was a significant discriminant between success and failure in group 1 (n = 15, χ2 = 11·5, P = 0·001) and in the overall group (n = 38, χ2 = 17·2, P<0·001). In group 2, four patients with good run‐off had an unsuccessful outcome; this was due in all cases to technical problems (haemorrhage in two and intimal dissection in two). In group 3, two patients with good run‐off had unsuccessful streptokinase infusions. In both cases the graft failed in the early postoperative period (<30 days). By contrast, the four patients whose grafts occluded after 30 days had successful streptokinase infusions and long‐term graft patency was achieved by further surgery and balloon dilatation. In all groups, no patient with a poor run‐off had a successful outcome following streptokinase administration. The role of local intra‐arterial streptokinase therapy in the critically ischaemic limb remains controversial, but these results suggest that an adequate run‐off is an important factor in the selection of patients for treatment.Keywords
This publication has 25 references indexed in Scilit:
- Local thrombolytic therapy of acute peripheral arterial ischaemia with tissue plasminogen activator: A dose-ranging studyBritish Journal of Surgery, 1988
- Pulse-generated runoff: a new method of determining calf vessel patencyBritish Journal of Surgery, 1988
- Streptokinase Treatment of Acute Arterial OcclusionAnnals of Surgery, 1983
- Local Low-Dose Thrombolytic Therapy of Peripheral Arterial OcclusionsNew England Journal of Medicine, 1982
- Low dose streptokinase in the treatment of arterial occlusionsAmerican Journal of Roentgenology, 1981
- Guidelines for the Use of Thrombolytic AgentsNew England Journal of Medicine, 1979
- Small-vessel thrombosis following vascular injury: Successful treatment with a low-dose intra-arterial infusion of streptokinaseBritish Journal of Surgery, 1971
- POPLITEAL ARTERY THROMBOSIS TREATED WITH STREPTOKINASEThe Lancet, 1962
- THE LYSIS OF ARTIFICIALLY INDUCED INTRAVASCULAR CLOTS IN MAN BY INTRAVENOUS INFUSIONS OF STREPTOKINASE*†JCI Insight, 1959
- THE FIBRINOLYTIC ACTIVITY OF HEMOLYTIC STREPTOCOCCIThe Journal of Experimental Medicine, 1933