THROMBOLYSIS THERAPY IN PATIENTS WITH FEMOROPOPLITEAL SYNTHETIC GRAFTOCCLUSIONS

BACKGROUND: The aim of this study was to evaluate the efficiency of th rombolysis in the presence of an occluded femoropopliteal synthetic gr aft, PATIENTS AND METHODS: Over a 3-year period, 46 occluded femoropop liteal grafts were treated with urokinase and reconstruction. The case s were divided into three groups: group 1 (n = 25), complete thromboly sis followed by reconstruction or angioplasty or both; group 2 (n = 5) , complete thrombolysis alone; and group 3 (n = 16), failure of thromb olysis requiring reconstruction or leading to amputation, Patients wer e closely observed after the treatment for more than 1 year, RESULTS: There are no fatal complications among patients with thrombolytic ther apy. In group 1, the 3-year patency rates were 12% and the 3-year limb salvage rates were 77%, In group 2, the 3-year patency rates and the limb salvage rates were 20% and 80%, respectively. The group 3 patency rates and the limb salvage rates were 8% and 40%, respectively. The b est results were achieved in patients who had thrombolysis followed by reconstruction (group 1) and in those who had thrombolysis alone (gro up 2), Limb salvage was poor in patients with failure of lytic therapy regardless of the reconstruction (P <0.01). CONCLUSION: The use of in tra-arterial urokinase followed by secondary vascular reconstructive p rocedures was studied, The patient with synthetic graft occlusion stil l has a reasonably favorable prognosis for long-term limb salvage when thrombolysis is successful.