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The objective of this study was to evaluate the impact of thrombolysis of synthetic
grafts before urgent vascular reconstruction. In 29 patients, 41 thrombosed synthetic
grafts that underwent intra-arterial thrombolysis were studied. The cases were divided
into three groups: group I—complete thrombolysis followed by reconstruction; group
II—complete thrombolysis alone; and group III—incomplete lysis requiring reconstruction
or sympathectomy. Follow-up ranged from 1 to 556 days (mean: 149 days). Kaplan-Meier
analysis was used to determine patency and limb salvage rates. One-year patency and
limb salvage rates were 53% and 95%, 34% and 67%, and 38% and 48%, respectively, for
groups I, II, and III. Eighteen complications occurred in 16 of the 41 (39%) episodes.
One patient died of intracranial hemorrhage. The best results were achieved when complete
lysis was followed by appropriate reconstruction. Patency was equally poor in complete
thrombolysis alone and reconstructions required by incomplete thrombolysis. Limb salvage
was better after complete thrombolysis, regardless of the appropriate reconstruction.
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Footnotes
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
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Copyright
© 1992 Reed Publishing USA. Published by Elsevier Inc.
