ACUTE PERIPHERAL ARTERIAL-OCCLUSION - PREDICTORS OF SUCCESS IN CATHETER-DIRECTED THROMBOLYTIC THERAPY

PURPOSE: To determine predictors of clot dissolution in patients under going catheter-directed urokinase thrombolysis for peripheral arterial occlusion (PAO). MATERIALS AND METHODS: The study included 103 patien ts with limb-threatening symptoms of embolism lasting 14 days or less and resulting from embolism (n = 20) or thrombosis (n = 83). Successfu l lysis was defined as restitution of antegrade flow with less than 20 % diameter reduction by residual thrombus. Stepwise logistic regressio n was used to analyze the data. RESULTS: Relevant clinical variables w ere diabetic status (odds ratio, 0.75; P = .04 for diabetic patients), conduit type (1.25; P = .04 for native artery and 1.51; P = .02 for p rosthetic graft), and number of arterial segments involved (1.60; P = .02 for one level and 1.42; P = .03 for two levels). Important procedu ral variables included intrathrombus positioning of catheter ports (od ds ratio, 7.40; P = .001) and guide wire passage through the occlusion (3.10; P = .003). Absolute thrombus volume was nonpredictive but corr elated with reperfusion time (P = .02) and infusion time (P = .01). CO NCLUSION: Predictive parameters may help in the selection of candidate s with PAO fbr thrombolytic therapy.