CONVENTIONAL LOCAL INTRAARTERIAL FIBRINOL YSIS, SPRAY LYSIS AND MECHANICALLY ACCELERATED FIBRINOLYSIS - ITS ROLE WITHIN THE SPECTRUM OF ANGIOPLASTY TECHNIQUES

intra-arterial local fibrinolysis was performed in 72 patients (51 men , 21 women, mean age 66.8 years) during the course of 78 angioplasties . 11.1% were stage II a (Fontaine), 38.9 % were stage II b, 27.8% were stage III and 22.2% were stage IV The methods used were conventional fibrinolysis (15.4%), spray lysis (47.4%) and mechanically accelerated fibrinolysis (37.2%). In 66.7% the urokinase dose was < 600,000 I. U. , in 17.9% it was > 1,000,000 I. U. Additional balloon dilatation was performed in 72 cases, percutaneous aspiration of thrombo-embolic mate rial in 41 cases and stent implantation in 7 cases. Angiographically t he procedure was successful in 90.7%; the Doppler index rose from 0.47 +/- 0.27 to 0.8 5 +/- 0.3 (p < 0.001). At discharge, staging was: I = 38.9%, II a = 38.9%, II b = 5.6%, III = 1.4%, IV = 15.3%. There were no systemic bleeding complications. In 5.1%, complications had to be t reated surgically.