THROMBOLYSIS OF LOWER-EXTREMITY EMBOLIC OCCLUSIONS - A STUDY OF THE RESULTS OF THE STAR REGISTRY

PURPOSE: To evaluate thrombolysis as primary therapy for lower extremi ty embolic occlusions. MATERIALS AND METHODS: Forty-five of 306 consec utive cases of lower extremity arterial occlusions treated with urokin ase and registered in the Society of Cardiovascular and Interventional Radiology Transluminal Angioplasty and Revascularization Registry wer e believed on the basis of clinical and angiographic findings to be du e to emboli. RESULTS: Comorbidity included atrial fibrillation in 50%, previous myocardial infarction in 40%, and a cerebrovascular event in 35%. Thirty-two (71%) limbs were viable, 12 (27%) were threatened, an d one had irreversible ischemia. Mean symptom duration was 8.6 days. A verage occlusion length was 17 cm. The distribution of emboli was 4% a ortoiliac, 65% femoropopliteal, 24% tibial, and 7% graft. Major compli cations occurred in eight of 45 patients (18%). The technical success rate was 69%, with a 1- and 2-year primary patency of 79% for initiall y successful intraarterial thrombolyses. CONCLUSION: Thrombolysis of e mbolic occlusions is successful in most cases. Limb salvage and surviv al rates are similar to historical reports for surgical embolectomy.