Medizinische Universität Graz - Research portal
Selected Publication:
Pilger, E; Decrinis, M; Stark, G; Koch, G; Obernosterer, A; Tischler, R; Lafer, M; Doder, A.
Thrombolytic treatment and balloon angioplasty in chronic occlusion of the aortic bifurcation.
Ann Intern Med. 1994; 120(1):40-44
Doi: 10.7326/0003-4819-120-1-199401010-00007
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- Leading authors Med Uni Graz
- Pilger Ernst
- Co-authors Med Uni Graz
- Obernosterer Andrea
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- Abstract:
- OBJECTIVE: To evaluate nonsurgical alternatives in reopening chronically occluded aortic bifurcation. DESIGN: Uncontrolled randomized study. SETTING: University-affiliated referral center for vascular diseases. PATIENTS: Twenty-five of 39 consecutive patients with chronic aortoiliac disease including a totally occluded aortic bifurcation were found to be acceptable candidates for an aortobifemoral prosthetic graft. INTERVENTION: Patients were randomly assigned to receive either streptokinase or urokinase or recombinant tissue-type plasminogen activator (rt-PA). In cases of successful thrombolysis and residual obstructions, subsequent balloon angioplasty was attempted. Prosthetic bypass grafting was done if thrombolytic treatment and balloon angioplasty failed. RESULTS: Complete lysis was achieved in 5 of 25 patients (20%). In 10 (40%) patients, lysis showed residual obstructions, which were reopened mechanically in 8 patients; 2 patients had extra-anatomical bypass grafts. Ten patients (40%) without thrombolysis had surgical aortobifemoral bypass grafts. Overall, recanalization and clinical improvement were achieved in 13 of 25 patients (52%) by thrombolytic therapy and subsequent balloon angioplasty. The recanalization rate did not differ among the different thrombolytic drugs. However, rt-PA therapy resulted in reopening after 4 days of treatment; streptokinase, after 6 days; and urokinase, after 9 days (P < 0.005). No major complications or deaths occurred. CONCLUSION: Thrombolytic treatment followed by balloon angioplasty may help avoid the need for aorto-bifemoral prosthetic bypass grafting in more than 50% of patients with chronic aortoiliac disease.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
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- Pilot Projects - drug therapy
- Random Allocation - drug therapy
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- Streptokinase - therapeutic use
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- Tissue Plasminogen Activator - therapeutic use
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