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Comparison of thrombolytic therapy of lower-extremity acute, subacute, and chronic arterial occlusions. 1998

M H Wholey, and M A Maynar, and M H Wholey, and J M Pulido-Duque, and R Reyes, and C R Jarmolowski, and W R Castaneda
Department of Interventional Radiology, Louisiana State University School of Medicine, New Orleans, USA.

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.

UI MeSH Term Description Entries
D007261 Infusions, Intra-Arterial Regional infusion of drugs via an arterial catheter. Often a pump is used to impel the drug through the catheter. Used in therapy of cancer, upper gastrointestinal hemorrhage, infection, and peripheral vascular disease. Infusions, Regional Arterial,Infusions, Intra Arterial,Infusions, Intraarterial,Arterial Infusion, Intra,Arterial Infusion, Regional,Arterial Infusions, Intra,Arterial Infusions, Regional,Infusion, Intra Arterial,Infusion, Intra-Arterial,Infusion, Intraarterial,Infusion, Regional Arterial,Intra Arterial Infusion,Intra Arterial Infusions,Intra-Arterial Infusion,Intra-Arterial Infusions,Intraarterial Infusion,Intraarterial Infusions,Regional Arterial Infusion,Regional Arterial Infusions
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010960 Plasminogen Activators A heterogeneous group of proteolytic enzymes that convert PLASMINOGEN to FIBRINOLYSIN. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. Extrinsic Plasminogen Activators,Plasminogen Activator,Uterine-Tissue Plasminogen Activator,Uterine Tissue Plasminogen Activator
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D004691 Endarterectomy Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called ATHERECTOMY. Thromboendarterectomy,Endarterectomies,Thromboendarterectomies
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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