PERIPHERAL ARTERIAL OCCLUSIVE DISEASE - A CUTE INTERVENTIONAL PROCEDURES AND POSTPROCEDURAL TREATMENT

Acute ischemia in peripheral arterial occlusive disease due to progres sive atherosclerosis is most commonly caused by thrombotic or thromboe mbolic events. Such a condition is a threat to both the limb and the l ife of a patient which requires rapid therapeutic decisions based on c lose cooperation between vascular surgeons, angiologists and radiologi sts. In complete ischemia with sensomotoric deficit and in suprainguin al occlusions surgical management remains the treatment of choice. Pat ients with incomplete ischemia and infrainguinal occlusions and patien ts unfit for major vascular surgery are appropriate candidates for loc al thrombolysis and percutaneous revascularization procedures. Availab le data on the main thrombolytic agents fail to show convincing differ ence between these drugs with regard to their efficacy and safety. Ful l heparinization is recommended before any definite therapy, after thr ombolysis and if necessary after percutaneous transluminal angioplasty (PTA). Antiplatelet drugs should be given before and after reconstruc tive surgery and PTA and following heparinization after thrombolysis a nd PTA. In all conditions long-term treatment with antiplatelet drugs is recommended.