Document Detail


Thrombolytic therapy for acute arterial occlusion.
MedLine Citation:
PMID:  7583985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The standard treatment of peripheral arterial occlusion has been operative, employing embolectomy, thrombectomy, or bypass grafting to restore blood flow to the compromised extremity. Intra-arterial thrombolysis has been advocated as an initial intervention designed to unmask the anatomic lesion responsible for the occlusive event, with a directed or endovascular modality thereafter. Four thrombolytic agents are in clinical use: streptokinase, urokinase, recombinant tissue plasminogen activator, and acylated plasminogen streptokinase activator complex. The agents differ with respect to efficacy of thrombolysis, fibrin specificity, and cost. At present, urokinase is the most widely used. Recent randomized clinical trials suggest a benefit of thrombolytic therapy in the initial management of acute peripheral arterial occlusion, with improved patient survival and similar amputation rates compared with immediate open intervention. Each modality has its place in specific patient subcategories; the determination of which patients are best served by a specific modality awaits the results of large clinical trials.
Authors:
K Ouriel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in general surgery     Volume:  -     ISSN:  1065-6243     ISO Abbreviation:  Curr Opin Gen Surg     Publication Date:  1994  
Date Detail:
Created Date:  1995-12-18     Completed Date:  1995-12-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9314670     Medline TA:  Curr Opin Gen Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-64     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Rochester Medical Center, NY 14642-8410, USA.
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MeSH Terms
Descriptor/Qualifier:
Angiography
Arterial Occlusive Diseases / drug therapy*,  radiography
Blood Vessel Prosthesis
Clinical Trials as Topic
Graft Occlusion, Vascular / drug therapy,  radiography
Humans
Ischemia / drug therapy*,  radiography
Leg / blood supply*
Thrombolytic Therapy / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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