Local thrombolysis in the treatment of thrombosed arteries, bypass grafts, and arteriovenous fistulas Robert A. Graor, M.D., Barbara Risius, M.D., Kevin.

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Presentation transcript:

Local thrombolysis in the treatment of thrombosed arteries, bypass grafts, and arteriovenous fistulas Robert A. Graor, M.D., Barbara Risius, M.D., Kevin M. Denny, M.D., Jess R. Young, M.D., Edwin G. Beven, M.D., Norman R. Hertzer, M.D., William F. Ruschhaupt, M.D., Patrick J. O'Hara, M.D., Michael A. Geisinger, M.D., Margaret G. Zelch, M.D. Journal of Vascular Surgery Volume 2, Issue 3, Pages 406-414 (May 1985) DOI: 10.1016/0741-5214(85)90093-X Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Patient presented with 4-week history of one-half block claudication. As shown by angiography, popliteal artery is occluded without significant evidence of tibial artery runoff. B, Following 48 hours of infusion popliteal and tibial arteries were patent. There were two areas of stenosis in popliteal artery. C, Popliteal artery following PTA. (From: Risius et al. Catheter directed low dose streptokinase infusion: A preliminary experience. Radiology 1948;150:349-55.) Journal of Vascular Surgery 1985 2, 406-414DOI: (10.1016/0741-5214(85)90093-X) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 A, A 57-year-old presented with three-quarters block claudication of 8 weeks' duration. As shown by angiography, common femoral artery is occluded with evidence of reconstitution of deep femoral and superficial femoral arteries. B, Intra-arterial digital subtraction angiogram demonstrates patency of common femoral artery. Area of calcified stenosis was amenable to endarterectomy. Journal of Vascular Surgery 1985 2, 406-414DOI: (10.1016/0741-5214(85)90093-X) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 A, A 66-year-old man with occlusion of right femoropopliteal graft for 2 days. B, After 96 hours of infusion, graft is patent. C, Graft is patent and distal runoff has been reestablished via anterior tibial artery. Patient had sequential grafting from distal existing graft to anterior tibial artery to bypass underlying stenosis. Journal of Vascular Surgery 1985 2, 406-414DOI: (10.1016/0741-5214(85)90093-X) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Fistulogram following thrombus lysis demonstrates two areas of stenosis that were subsequently surgically revised. Journal of Vascular Surgery 1985 2, 406-414DOI: (10.1016/0741-5214(85)90093-X) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions