Results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg.

Abstract

To observe immediate and late results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg. A total of 212 patients treated with Actilyse® at the University Hospital of North Norway because of acute arterial ischaemia of the leg during the period 01 January 2000-30 June 2006 were analysed retrospectively. The radiologic outcome was judged to be successful in 101 (48%), adequate in 80 (38%) and failed in 31 (14%). At 1-year follow-up, 158 (75%) were alive without amputation, 14 (7%) were alive with amputation, 20 (9%) were dead without amputation and 20 (9%) were dead with amputation. Altogether, 34 (16%) were amputated and 40 (19%) were dead after 1 year. After an average observation period of 3.25 years, 111 (52%) were alive without amputation, 16 (8%) were alive with amputation, 60 (28%) were dead without amputation and 25 (12%) were dead with amputation. A total of 41 (19%) were amputated and 85 (40%) were dead. Fifty complications were registered; 30 (14%) patients had a compartment syndrome, eight (4%) had cerebral stroke and 12 (6%) had a myocardial infarction. The results are at least as good as historic controls and similar to international series. Especially, it appears as though the long-term results are somewhat better. The complication rate and morbidity are less than in surgery alone.