Catheter Thrombolysis with Streptokinase, Urokinase, and Recombinant Tissue Plasminogen Activator for Peripheral Arterial Occlusion

Abstract

Percutaneous transluminal angioplasty (PTA) of peripheral arteries has so far been limited to relatively short lesions which should not be too solidified for penetration by the instrument or too fresh because of the danger of embolization into the runoff vessels during manipulation [4, 7]. The introduction of intraarterial local catheter thrombolysis (CTL) has made possible the catheter treatment of acute and subacute thrombotic occlusions including extensive lesions [3, 8–11]. CTL with low-dose streptokinase or urokinase is a procedure with a low risk and with satisfactory long-term patency in patients with femoropopliteal occlusions. A new tissue-type plasminogen activator produced by recombinant technology (rt-PA) that possesses advantages over conventional thrombolytic agents seems to hold promise for more potent and selective lysis of peripheral arterial thrombotic occlusions [1]. In this paper we present technique and dosage of the application of these three thrombolytic drugs, and the results obtained with these modalities in 142 patients from 1982 through 1987.