1997 Volume 18 Issue 4 Pages 15-20
PURPOSE: To assess the results of laser angioplasty combined with thrombolysis by intraarterial infusion of urokinase for complete occlusions of the pelvic and lower limb arteries.
MATERIALS AND METHODS: Since 1986 through 1995, 41 of complete occlusion cases were treated with PTLA combined with thrombolysis by intraarterial infusion of urokinase. All patients were in high risks group and considered inoperable. 1060nm CW Nd: YAG laser was used for PTLA and two types of laser probe were used for laser irradiation by contact method, and various types of angioscopy were used for assessment before and after laser irradiation. Urokinase was directly infused into the thrombi in wedge state at the rate of 1-2×104 units/min.. The total doses of urokinase were ranged from 6 to 90×104 units. Conventional balloon dilatation was added after the procedure, if needed.
RESULTS: Angioscopy was useful in differentiating atheromatous lesions from thrombi and has contributed in planning how to treat the lesions. Occlusive arteries were recanalized in 31 of 41 cases with satisfactory results, the initial success rate was about 76%. The 1-year cumulative patency rate of complete occlusive lesions was about 67%, 2-year 60%, 3-year 50%and 5-year 46%. Complications such as distal embolism, dissection and others were noted.
CONCLUSIONS: PTLA combined with thrombolysis is very useful in treating occlusion of arteries.
