Morphological Abnormalities Revealed after Successful Intra-Arterial Thrombolysis of Infra-Inguinal Native Arteries and Bypasses

Purpose: To characterise morphological abnormalities depicted after successful intra-arterial thrombolysis; to determine whether these differed in infrainguinal native arteries and bypasses; and to evaluate whether ballon angioplasty was an appropriate treatment of stenoses in the acute phase after thrombolysis.

Material and Methods: Patient records, radiology records, and angiograms from 47 patients with acute or subacute occlusions of infra-inguinal arteries (n=21) or bypasses (n=26) successfully treated with continuous intra-arterial infusion of streptokinase, urokinase or tissue plasminogen activator were retrospectively reviewed.

Results: Angiographic morphological abnormalities were depicted in 18 of 21 arteries (86%) and in 23 of 26 bypasses (88%), the most common abnormality being stenoses. Haemodynamically significant stenoses were found in 15 arteries (71%) and 18 bypasses (69%). The majority of the stenoses were successfully treated with balloon angioplasty, both in native arteries (12/15; 80%) and in bypasses (14/18; 78%).

Conclusion: Morphological abnormalities are most often shown after successful intra-arterial thrombolysis in arteries, autogenous and non-autogenous bypasses. In all types of conduits, stenoses are the most commonly revealed lesion, which in the majority of cases can be treated with balloon angioplasty. Shortterm outcome after catheter-directed thrombolysis and angioplasty seems fair.