MODIFIED TECHNIQUE OF LOCAL RT-PA CATHETE R THROMBOLYSIS

Purpose: To develop an economic and efficient concept for more time-sa ving local rt-PA thrombolysis therapy. Method: 40 patients with periph eral vascular occlusive disease stage IIb-III according to the Fontain e classification and with angiographically proven occluded segments of pelvic and lower limb arteries were treated by a modified concept of local rt-PA catheter thrombolysis. Via a thin guide wire the catheter for thrombolysis is slowly advanced through the thrombus without fluor oscopic control, outside the room in which angiography is performed. i n 24 cases a short-term lysis and in 16 cases a Long-term lysis was ca rried out. Results: The initial success rate was 75 %, the patency rat e in six months' follow-up was 66.7 %. The ankle-brachial index decrea sed from 0.4+/-0.3 to 0.8+/-0.2 on the average. There were no relevant clinical complications. The average occupancy time of the angiography room or table was 60+/-52 min, the average time of fluoroscopy was 17 +/-13 min. Conclusion: In modified local rt-PA thrombolysis, shortterm lysis and long-term lysis were mostly performed outside the angiograp hy room, so that the exposure to radiation and there fore the radiatio n dose were reduced for both the patient and the attending staff. The angiography room is thus available for other patients and can therefor e be used more efficiently.