ISOLATED LIMB PERFUSION WITH HEART-LUNG M ACHINE FOR INTRAOPERATIVE FIBRINOLYSIS OF THROMBOTIC VASCULAR OCCLUSIONS

Following an unsuccessful surgical thrombectomy thrombotic occlusions in the deep veins (n = 47) and in the arteries (n = 24) of the lower l imbs were treated with an intraoperative fibrinolysis. We used the tec hnique of isolated limb perfusion with heart-lung machine to establish an isolated circulation in the extremity. This allowed us to use extr emely high dosages of streptokinase (1 000 000 i.U.) or recombinant ti ssue plasminogen activator (30-50 mg; n = 47). During the fibrinolysis we protected the body circulation with the antifibrinolytic agent apr otinine (500 000 K.i.U.). With this regimen serious hemorrhagic compli cations could be prevented. The fibrinolysis was successful in 14 (58% ) cases of arterial thrombosis and in 35 (74%) cases of deep vein thro mbosis.