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Vascular and Endovascular Surgery
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Regional Thrombolysis for Peripheral Arterial Occlusions: Initial Procedure of Choice?

Case Reports

Eli Anker

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Ira J. Schneider

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Alexander Melman

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Terry Palatt

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Howard Wexler

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Bradley Cohen

Department of Surgery, Division of Vascular Surgery, Good Samaritan Hospital, West Islip, and Southside Hospital, Bay Shore, New York

Five cases, representative of our larger series, are described in which grafts and lower extremities of patients with peripheral arterial occlusions were salvaged by thrombolytic therapy with catheter-directed intra-arterial urokinase. These patients were poor surgical candidates due to serious medical problems in addition to their occlusions. Intra-arterial fibrinolysis restored arterial flow and revealed lesions suitable for percutaneous angioplasty, making surgical intervention unnecessary. As vascular surgeons and interventionalists, the authors believe that thrombolysis is underutilized in patients with lysable occlusions.

Vascular and Endovascular Surgery, Vol. 27, No. 9, 701-708 (1993)
DOI: 10.1177/153857449302700908
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