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Vascular and Endovascular Surgery
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Streptokinase Lysis of Arterial Thrombus Threatening Renal Allograft — A Case Report

Jonathan A. Mandelbaum

Ohio State University College of Medicine, Department of Surgery, Division of Transplantation, Columbus, Ohio

Mitchell L. Henry

Ohio State University College of Medicine, Department of Surgery, Division of Transplantation, Columbus, Ohio

Bruce G. Sommer

Ohio State University College of Medicine, Department of Surgery, Division of Transplantation, Columbus, Ohio

William L. Smead

Ohio State University College of Medicine, Department of Surgery, Division of Transplantation, Columbus, Ohio

Ronald M. Ferguson

Ohio State University College of Medicine, Department of Surgery, Division of Transplantation, Columbus, Ohio

This case report describes a diabetic patient with an arterial thrombus lo cated in the common iliac artery, just proximal to the takeoff of the renal artery to a transplanted kidney. The clinical problem was how to preserve both lower extremity perfusion and allograft function while lysing the thrombus. Thera peutic options considered were: (1) blind femoral thrombectomy using a Fo garty Catheter, (2) renal artery isolation and open thrombectomy, (3) selective intraarterial streptokinase infusion, and (4) systemic intravenous streptokinase infusion. The fourth option was chosen and resulted in complete dissolution of the thrombus while avoiding further distal embolization and renal transplant infarction.

Vascular and Endovascular Surgery, Vol. 21, No. 6, 431-435 (1987)
DOI: 10.1177/153857448702100611
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