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When is Thrombolysi...
When is Thrombolysis for Acute Lower Limb Ischemia Worthwhile?
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Plate, G. (author)
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Oredsson, S (author)
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- Lanke, Jan (author)
- Lund University,Lunds universitet,Statistiska institutionen,Ekonomihögskolan,Department of Statistics,Lund University School of Economics and Management, LUSEM
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(creator_code:org_t)
- Elsevier BV, 2009
- 2009
- English.
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 37:2, s. 206-212
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http://dx.doi.org/10...
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Abstract
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- Objectives: To find variables associated with outcome following thrombolytic treatment for acute lower limb ischemia. Design: Re-analysis of a prospective multicentre study. Material and methods: One hundred and twenty-one patients with acute lower limb ischemia previously included in a randomised study comparing high- with low-dose thrombolysis were re-analysed ignoring the mode of lytic treatment. All possibly predictive variables were subjected to multivariate analyses to find associations with outcome. Results: Previous successful thrombolysis, ankle-brachial index over 0.33, absence of motor dysfunction, presence of cardiac arrhythmia, and lysis of a vascular graft were all associated with successful thrombolysis (p = 0.003). Previous thrombolysis, age less than 70 years, and ankle-brachial index over 0.33 were all perfect predictors of absence of life-threatening complications or death. Successful lysis, age < 70, and lysis of a native artery as opposed to a vascular graft were all associated with clinical success (preserved patency, limb, and life) after one year (p = 0.002). Conclusions: Previous thrombolysis, age under 70 years, and non-severe ischemia predict successful thrombolysis free from severe complications. Successful thrombolysis is strongly predictive of amputation-free survival with vascular patency for at least one year. Occluded grafts could often be reopened, but long-term outcome is better after thrombolysis of native arteries. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Ischemia
- Lower extremity
- Arterial occlusive disease
- Thromboembolism
- Thrombolytic therapy
Publication and Content Type
- art (subject category)
- ref (subject category)
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