Role of Thrombolytic Therapy in Treatment of Acute and Critical Limb Ischemia

Abstract

Being informed of ‘‘a patient in the emergency room with a cold leg’’ is often the initial step in the diagnosis and treatment of acute limb ischemia.  Techniques of catheter directed thrombolysis 79 These patients remain a significant portion of those needing urgent or emergent vascular interventional treatment. Because a significant percentage of patients with acute limb ischemia are best served by primary open surgical treatment, evaluation and management ought to be a collaborative effort by an interventional radiologist and a vascular surgeon. The SVS/ISCVS classification of acute limb ischemia should be used as the main instrument for triage. Intrarterial Catheter directed Thrombolysis became a primary choice of treatment in many situations of acute and critical lower limb ischemia rather than a choice in hand beside or instead of surgical and endovascular interventions. A thorough reading for review of literature, good command of endovascular skills, proper orientation of contraindications and complications of the procedure are of great importance to master the procedure. More studies have to deal with new thrombolytic agents and new modalities and techniques of thrombolysis in the aim of avoiding the known complications.  Techniques of catheter directed thrombolysis 80