Local thrombolysis in the treatment of arterial graft occlusions

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Presentation transcript:

Local thrombolysis in the treatment of arterial graft occlusions A. van Breda, M.D., J.C. Robison, M.D., L. Feldman, M.D., A.C. Waltman, M.D., D.C. Brewster, M.D., W.M. Abbott, M.D., C.A. Athanasoulis, M.D. Journal of Vascular Surgery Volume 1, Issue 1, Pages 103-112 (January 1984) DOI: 10.1016/0741-5214(84)90190-3 Copyright © 1984 Mosby, Inc. Terms and Conditions

Fig. 1 Patient 4. A, Initial aortogram demonstrates complete occlusion of right limb of aortofemoral graft. B, After 8-hour infusion of streptokinase, graft limb is completely patent. Restoration of perfusion permitted palpation of a pseudoaneurysm at distal anastomosis. Journal of Vascular Surgery 1984 1, 103-112DOI: (10.1016/0741-5214(84)90190-3) Copyright © 1984 Mosby, Inc. Terms and Conditions

Fig. 2 Patient 10. A, Twelve-day history of occlusion of saphenous vein femoropopliteal graft. Initial angiogram demonstrates occlusion at graft origin (arrow). B, Twenty-four—hour infusion of streptokinase produced complete graft thrombolysis and revealed two stenoses of vein graft valves (arrow) as well as a distal anastomotic stenosis. C, Completely patent graft after thrombolysis and angioplasty of stenoses (arrows). Journal of Vascular Surgery 1984 1, 103-112DOI: (10.1016/0741-5214(84)90190-3) Copyright © 1984 Mosby, Inc. Terms and Conditions

Fig. 3 Patient 6. A, Complete occlusion of 7-day-old umbilical vein femoropopliteal graft. Initial angiogram demonstrates thrombus extending into anterior tibial artery (arrow). B, Contrast injection demonstrates thrombus completely filling graft. C and D, Patent graft after 24-hour streptokinase infusion. No cause of thrombosis was found. Graft remained patent on anticoagulants. Journal of Vascular Surgery 1984 1, 103-112DOI: (10.1016/0741-5214(84)90190-3) Copyright © 1984 Mosby, Inc. Terms and Conditions