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A retrospective study examining thrombolysis for occluded femoro-popliteal grafts - Is it worthwhile?
MedLine Citation:
PMID:  21875696     Owner:  NLM     Status:  Publisher    
AIM: To assess the effectiveness of catheter directed thrombolysis (CDT) in the treatment of acute graft occlusion. METHODS: Tissue prothrombin activator (rt-PA) was the sole agent used for thrombolysis. This was infused through a 4F straight 65 cm catheter placed under ultrasound guidance. Following a pre-CDT angiogram, a catheter was placed just proximal to the distal anastomosis. An infusion of rt-PA was given over 24 h. An assessment of acute clinical success, limb salvage rates, patency rates and complication rates were made over a period of one year. RESULTS: 80% (20/25) of grafts were successfully reopened immediately. 4/5 (80%) of the unsuccessful CDT cases required amputation within a few weeks. 60% (12/20) of successful CDT cases had an underlying stenotic lesion which required angioplasty. Limb salvage rate was 72% (18/25) at 12 months. There was no CDT related mortality. Secondary patency rate at 9 months was 76% (13/17). CONCLUSION: CDT can achieve reasonable results in this group of challenging patients and may be seen as a useful accessory in the vascular toolkit. However, precise indications for its use need further clarification.
C U Abraham-Igwe; M R S Siddiqui; L T Geddes; J Halls; A Irvine; N Browning
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-23
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  -     ISSN:  1743-9159     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Department of Surgery, St Helier Hospital, Surrey, UK.
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