THERAPEUTIC EFFICIENCY OF PULSED SPRAY LY SIS IN PERIPHERAL ARTERIAL OCCLUSIONS

Purpose: To determine the clinical efficacy of pulse-spray thrombolysi s. Material and methods: In a prospective trial 28 patients with acute arterial (n = 14) and bypass (n = 14) occlusions of the lower extremi ties were treated with pulse-spray thrombolysis. 23/28 legs were at ri sk. Results: Technical and clinical success were 89% and 68% respectiv ely. Time interval until restitution of antegrade now was less than tw o hours, the median duration of the complete intervention was 17 hours . Two patients (7.1%) needed transfusions for inguinal haematomas. Aft er six months 50% of occluded segments remained patent, secondary pate ncy is comparable at 53%. By passes show significantly lower patency ( p = 0.04) and higher amputation (p = 0.009) rates than native arteries . Bad run-off (less than or equal to 1 artery patent) is a significant predictor for clinical failure and early amputation. Conclusions: The distinct advantage of pulse-spray thrombolysis is fast restoration of antegrade flow and thereby effective treatment of acute ischaemia. Th e complication rate is low without associated mortality.