Intraoperative intra-arterial urokinase therapy after failed embolectomy in acute XXXX .

@entity1 @entity583 @entity1410 @entity63
BACKGROUND: Aim of this study is to evaluate the use of intraoperative intra-arterial urokinase infusion (IIUI) in overcoming residual thrombi after thromboembolectomy in acute @entity63 . METHODS:                 <AbstractText Label="DESIGN" NlmCategory="METHODS">retrospective study over a 3-year period. SETTING: University affiliated hospital. @entity1 : 21 @entity1 with acute @entity63 who underwent IIUI after embolectomy (18 transfemoral, 3 transpopliteal) had failed to achieve adequate distal perfusion. Postoperatively, all @entity1 were maintained on full dose heparinization. MAIN OUTCOME MEASUREMENTS: complete or partial clot lysis on post-IIUI angiography; restoration of pedal pulses and a viable leg at discharge. RESULTS: Angiographically, complete and partial lysis was demonstrated in 14 and 3 @entity1 , respectively. Two @entity1 with prolonged @entity63 required fasciotomy. One of these eventually had an amputation. Altogether, limb amputations (1 above knee, 2 below knee) were necessary in 3 @entity1 . The angiographic appearance of lysis correlated well with the restoration of pedal pulses and/or limb viability. One @entity1 died of @entity583 3 days after the procedure. Postoperatively, there were 5 (24%) wound @entity1410 of which 1 required surgical exploration. Over a mean follow-up period of 8 months (range 1-16), limb salvage was sustained in the 17 @entity1 with successful angiographic lysis. CONCLUSIONS: IIUI is an effective therapeutic adjunct to failed embolectomy in acute @entity63 . Use of this procedure is recommended as part of the routine management in such cases.
