Indicazioni e risultati delle fibrinolisi transcatetere nelle occlusioni arteriose acute

The authors' experience is reported on intravascular fibrinolytic therapy with urokinase in acute arterial obstructions. Thirty-eight patients were treated, from 1983 to 1986, for acute thrombosis and/or thromboembolization, 22 of which developed on an atherosclerotic lesion, and 10 on a surgical stenotic by-pass graft. A complete vascular recanalization has been obtained, at the end of the procedure, in 69.4% of the cases, 77.7% had a definite final clinical improvement. The results correspond to the medium statistical level of the various casuistics analyzed for comparison. Surgery has been performed on 27.7% of the patients. Complications have been observed in 8% of the cases. IAF technique is of greatest value in the treatment of those lesions; better results have been obtained with intra-thrombus injection of the drug (as emphasized by many authors) in association with PTA and surgery. A close cooperation between interventional radiology, vascular surgery and angiology is therefore necessary in this field.