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- Title
Intra-arterial streptokinase infusion in acute lower limb ischaemia.
- Authors
Scott, D. J. A.; Wyatt, M. G.; Wilson, Y. G.; Murphy, P.; Baird, R. N.; Horrocks, M.
- Abstract
Between 1986 and 1988, 38 patients (29 men and nine women), median age 65 years (range 38-85 years), underwent local intra-arterial streptokinase therapy for acute lower limb ischaemia. Three patient groups were identified: 15 with acute on chronic ischaemia (group 1), 12 postangioplasty (group 2) and 11 postfemorodistal bypass (group 3). Distal arteriographic run-off was a significant discriminant between success and failure in group 1 (n = 15, χ2 = 11·5, P = 0·001) and in the overall group (n = 38, χ2 = 17·2, P<0·001). In group 2, four patients with good run-off had an unsuccessful outcome; this was due in all cases to technical problems (haemorrhage in two and intimal dissection in two). In group 3, two patients with good run-off had unsuccessful streptokinase infusions. In both cases the graft failed in the early postoperative period (<30 days). By contrast, the four patients whose grafts occluded after 30 days had successful streptokinase infusions and long-term graft patency was achieved by further surgery and balloon dilatation. In all groups, no patient with a poor run-off had a successful outcome following streptokinase administration. The role of local intra-arterial streptokinase therapy in the critically ischaemic limb remains controversial, but these results suggest that an adequate run-off is an important factor in the selection of patients for treatment.
- Publication
British Journal of Surgery, 1991, Vol 78, Issue 6, p732
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1002/bjs.1800780630