Early Experience of Catheter Lysis

Abstract

The purpose of catheter lysis — local low-dose fibrinolytic therapy — is to offer the benefit of lysis without the risks of systemic fibrinolytic therapy. The primary success of angioplasty is limited by the length of the occlusion. Acute reocclusion occurs in about 50% of the cases when the length is more than 10 cm [16]. The primary results of the routine Dotter procedure are occasionally complicated by acute reocclusions and in rare cases by embolism. The latter occurs if the occlusion is acute or of less than 3 months duration. In such instances the combination of angioplasty with fibrinolytic therapy is suggested [1, 2, 4–6, 9, 10, 12, 15]. Two different methods are possible: (a) treatment of an acute embolus or occlusion by means of systemic fibrinolysis; and (b) the application of low-dose fibronolytic therapy using an angioplasty catheter [3, 6, 10, 12, 14, 15]. In 1980 Hess [5] and co-workers described good results in local low-dose fibrinolytic catheter therapy for femoropopliteal artery occlusions (70% success with 136 treatments).