LYSIS BLOCK TREATMENT - A NEW FORM OF LOCAL THROMBOLYSIS

Lysis block treatment (LBT) is a new form of fibrinolytic therapy for deep vein thrombosis and arterial occlusion in the distal parts of the limbs. Strictly local lysis was achieved by placing a cuff around the thigh or the upper arm, inflating the cuff to a pressure of 500 mmHg (''Bier's blockade''), and giving heparin and tissue plasminogen activ ator (rt-PA) by intravenous injection into the dorsal pedis or antecub ital veins. Occlusion lasted for one hour. This new technique was demo nstrated in 22 patients. Six patients presented with popliteal vein th romboses and 1 patient with a distal femoral vein thrombosis. In addit ion, 15 arterial occlusions were treated comprising 3 calf, 6 poplitea l, 3 distal femoral, and 2 digital sites and 1 brachial site. Five of 7 venous and 9 of 15 arterial occlusions were partially or totally rem oved. The activated partial thromboplastin time remained nearly unchan ged during LBT and only a limited and short-term lengthening was recor ded after restoration of blood flow. This was of importance for patien ts with bleeding tendencies, which are normally a contraindication for systemic lysis. LBT may therefore be considered as a useful alternati ve to systemic fibrinolytic treatment.