The value of preoperative lytic therapy in limb-threatening acute ischemia from popliteal artery aneurysm

• Verfasst von: Hölting, Thomas [VerfasserIn]
• Verfasst von: Paetz, Burkhard [VerfasserIn]
• Verfasst von: Richter, Götz Martin [VerfasserIn]
• Verfasst von: Allenberg, Jens-Rainer [VerfasserIn]
• Titel: The value of preoperative lytic therapy in limb-threatening acute ischemia from popliteal artery aneurysm
• Verf.angabe: Thomas Hoelting, Burkhard Paetz, Goetz M. Richter, Jens R. Allenberg
• Jahr: 1994
• Umfang: 5 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 8. Dezember 2005 ; Gesehen am 14.09.2023
• Titel Quelle: Enthalten in: The American journal of surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1926
• Jahr Quelle: 1994
• Band/Heft Quelle: 168(1994), 3, Seite 227-231
• ISSN Quelle: 1879-1883
• DOI: doi:10.1016/S0002-9610(05)80191-6
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1859550002

Abstract

In a retrospective study, we analyzed our experiences in 24 patients with acute ischemia from popliteal artery aneurysms over a period of 27 years and evaluated the value of a preoperative lytic therapy as an adjunct to surgical revascularization, compared to surgery alone. Preoperative urokinase therapy revealed a satisfactory improvement of the runoff in all cases. Follow-up angiography showed complete lysis in 6 and incomplete lysis in 3 of 9 patients. In contrast, in patients treated by surgery alone, postoperative angiography showed residual clots in all cases. The overall amputation rate was 25% (6/24) in 24 popliteal aneurysms with acute ischemia, including four patients with primary amputation for irreversible gangrene. Bypass grafting alone resulted in an early amputation rate of 9% (1/11) and occlusive complications of 45% (5/11) compared to no limb loss and no bypass complication in patients who underwent combined surgery and preoperative lysis (0/9). Our results underline the value of preoperative lytic therapy as an important factor in the management of acute ischemia in popliteal artery aneurysms.