Low dose intraarterial thrombolysis with XXXX : does it deliver as promised?

@entity1 @entity6 @entity1456 @entity887 @entity432 @entity715 @entity204
The widespread use of intraarterial thrombolytic therapy has been based on perceived benefits over operative treatment and the downgrading of the magnitude of subsequent surgery. Thirty-three @entity1 who had thrombolysis for peripheral @entity432 were retrospectively analyzed at St. James's Hospital from 1991 to 1997. One @entity1 received streptokinase unsuccessfully. Five other @entity1 's records were inadequate for analysis. Twenty-seven @entity1 's notes were analyzed for risk, duration of @entity432 , duration of treatment, dosage of @entity1456 ( @entity1456 ) and conduits thrombolysed. There were 15 males and 12 females. The mean age was 62 years (range, 20-87). Fourteen were current or reformed smokers. Five were @entity6 . Indications for treatment included acute graft @entity432 (n=13), @entity887 (n=6), and primary and secondary arterial @entity715 (n=8). Duration of @entity432 was less than 24 hours in seven, 1 to 7 days in ten, and more than 7 days in ten @entity1 . Twelve (44.44%) @entity1 had complete clot lysis, four (14.81%) had partial clearance, and 11 (40.74%) remained occluded. Eight (29.63%) had serious complications including one @entity204 . Eighteen (66.66%) @entity1 needed further surgical intervention to maintain graft patency. Data were analyzed using the chi-square and pooled t test. No significant difference was observed in results from thrombolysis from different conduits, gender, etiology, or smoking history. Increased duration of @entity1456 administration was associated with an increased risk of failure. Administration of total dosages greater than 60 mg was associated with a higher risk of failure. @entity6 had a poor outcome (p=0.0520). Only 44 % of @entity1 successfully underwent lysis. A primary surgical option may be a more sensible course than lysis, given that the vast majority of @entity1 ended up having surgery anyway.
