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When is Thrombolysis for Acute Lower Limb Ischemia Worthwhile?

Plate, G.; Oredsson, S and Lanke, Jan LU (2009) In European Journal of Vascular and Endovascular Surgery 37(2). p.206-212
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ischemia, Lower extremity, Arterial occlusive disease, Thromboembolism, Thrombolytic therapy
in
European Journal of Vascular and Endovascular Surgery
volume
37
issue
2
pages
206 - 212
publisher
Elsevier
external identifiers
  • wos:000263355300014
  • scopus:58549083749
ISSN
1532-2165
DOI
10.1016/j.ejvs.2008.11.010
language
English
LU publication?
yes
id
b32a6472-0b49-4f69-9393-82d6871141af (old id 1372504)
date added to LUP
2009-05-08 17:34:49
date last changed
2017-08-27 05:02:42
@article{b32a6472-0b49-4f69-9393-82d6871141af,
  abstract     = {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 &lt; 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.},
  author       = {Plate, G. and Oredsson, S and Lanke, Jan},
  issn         = {1532-2165},
  keyword      = {Ischemia,Lower extremity,Arterial occlusive disease,Thromboembolism,Thrombolytic therapy},
  language     = {eng},
  number       = {2},
  pages        = {206--212},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {When is Thrombolysis for Acute Lower Limb Ischemia Worthwhile?},
  url          = {http://dx.doi.org/10.1016/j.ejvs.2008.11.010},
  volume       = {37},
  year         = {2009},
}