Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Objective: Acute lower limb ischemia remains a challenging clinical dilemma. The purpose of this study was to assess the short term outcomes in patients treated for ALI with catheter directed intra-arterial thrombolysis. Design: case series. Methods: twenty patients with ALI of the lower extremities treated via endovascular catheter directed thrombolysis were identified and reviewed. Procedural success, duration of ALI,limb salvage and 30-day survival and short-term outcomes were obtained & compared to other studies. Results: A total number of 20 limbs were treated in 20 patients presenting with ALI (Rutherford class I, class IIa). The follow-up period was 3 months. Indications for intervention included, thrombosed bypass graft, thrombosed stent and native artery thrombosis .Technical success was achieved in 70% of cases, with a 30-day mortality rate of 10%. Procedural complications included access site hematoma (20%), and distal embolization (10%). Further surgical revascularization procedures were required in 20% of patients. The overall rate of major amputation was 5% .and the 3 months patency rate was 100% for successful cases. Conclusion:The results of our study reaffirm the belief that thrombolysis remains a safe and effective alternative to surgery for treating ALI. Thrombolysis did not lead to a high rate of bleeding complications as often feared and failure of thrombolysis does not necessarily prevent a successful surgical intervention or lead to amputation

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