| Thrombolytic therapy in peripheral arterial disease. | |
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MedLine Citation:
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PMID: 15379617 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The two main causes of peripheral arterial occlusion (PAO) are embolism and thrombosis. Surgical treatment of acute limb ischemia, because of related complications, has a 30-day mortality rate of 15% to 25%. Intra-arterial thrombolysis for lower extremity ischemia is a well-accepted and frequently used technique. It may offer definitive treatment without the need for major surgery in a significant series of patients with acute occlusion of a native leg artery or a by-pass graft. Thrombolysis can offer several potential advantages when compared with surgical therapy. Thrombolytic agents include streptokinase (SK), urokinase (UK), pro-UK and recombinant tissue plasminogen activators (rt-PA-Alteplase and r-PA-Reteplase). All these agents induce a systemic fibrinolytic state. Three prospective randomized trials, ROCHESTER, STILE, and TOPAS, which compared thrombolytic therapy with traditional surgical revascularization for lower limb ischemia, have recently been published. They suggest that thrombolysis, as an initial therapy, reduces the risk of subsequent surgery and improves limb salvage for patients with PAO. Using this approach, the underlying lesions can be identified and treated by transluminal balloon angioplasty or stenting, or by elective surgical revascularization. However, severe bleeding is still a non rare complication of intra-arterial thrombolysis and the risk of intracranial hemorrhage is 1-2%. |
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Authors:
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D Giannini; A Balbarini |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current drug targets. Cardiovascular & haematological disorders Volume: 4 ISSN: 1568-0061 ISO Abbreviation: Curr Drug Targets Cardiovasc Haematol Disord Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-09-21 Completed Date: 2005-03-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 101123341 Medline TA: Curr Drug Targets Cardiovasc Haematol Disord Country: Netherlands |
Other Details:
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Languages: eng Pagination: 249-58 Citation Subset: IM |
Affiliation:
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Cardiac and Thoracic Department, Unit of Angiology, University of Pisa, Italy. da.giannini@ao-pisa.toscana.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arterial Occlusive Diseases
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drug therapy*,
etiology Fibrinolytic Agents / administration & dosage, therapeutic use Foot / blood supply Humans Ischemia / drug therapy, etiology, surgery Leg / blood supply Peripheral Vascular Diseases / drug therapy*, etiology Practice Guidelines as Topic Randomized Controlled Trials as Topic Thromboembolism / complications, drug therapy Thrombolytic Therapy* / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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