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Vascular and Endovascular Surgery
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Effect on Thrombolysis and its Complication of Graft Occlusion and Specific Risk Factors

Yasuharu Ikeda

Department of Surgery, Hahnemann University Hospital

Hiroya Wada

Department of Surgery, Hahnemann University Hospital

Mark C. Rummel

Department of Surgery, Hahnemann University Hospital

Charles K. Field

Department of Surgery, Hahnemann University Hospital

Pankaj K. Bhatnagar

Department of Surgery, Hahnemann University Hospital

Paul A. Khoury

Department of Radiology, Hahnemann University Hospital, Philadelphia, Pennsylvania

Audrey R. Wilson

Department of Radiology, Hahnemann University Hospital, Philadelphia, Pennsylvania

Morris D. Kerstein

Department of Surgery, Hahnemann University Hospital

Teruo Matsumoto

Department of Surgery, Hahnemann University Hospital

The objective of this study was to correlate the initial outcome of thrombolytic therapy in patients with specific risk factors who presented with an occluded synthetic graft. Seventy-seven angiographically documented occluded synthetic grafts were treated with urokinase. All patients presented within thirty days of occlusion. The cases were investi gated according to specific risk factors: smoking (SM), hypertension (HT), coronary artery disease (CAD), and diabetes mellitus (DM). A high number of occlusions occurred in patients had a history of heavy smoking (84.4%). Complete thrombolysis was achieved in 46 of 77 (59.7%) graft occlusions. Thirty-eight of 65 (58.5%) occlusions in patients who smoked, 29 of 47 (61.7%) occlusions in patients with HT, 22 of 36 (61.1%) occlu sions in patients with CAD, and 18 of 25 (72.0%) occlusions in patients with DM were completely lysed. When comparison was made between the specific risk factors, no signif icant difference was found in complete lysis. Forty-seven complications occurred in 31 (40.3%) of 77 cases. One patient (1.3%) suffered from a fatal intracranial hemorrhage. No significant increase in complications was seen when the various risk factors were compared.

In conclusion, no relation was observed between the initial success rate with throm bolytic therapy and multiple risk factors in patients with arterial graft occlusion.

Vascular and Endovascular Surgery, Vol. 29, No. 6, 443-448 (1995)
DOI: 10.1177/153857449502900602
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