Results of Catheter-directed Endovascular Thrombolytic Treatment of Acute Ischaemia of the Leg

Abstract Objectives To observe immediate and late results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg. Design, material and methods A total of 212 patients treated with Actilyse® at the University Hospital of North Norway because of acute arterial ischaemia of the leg during the period 01 January 2000–30 June 2006 were analysed retrospectively. Results The radiologic outcome was judged to be successful in 101 (48%), adequate in 80 (38%) and failed in 31 (14%). At 1-year follow-up, 158 (75%) were alive without amputation, 14 (7%) were alive with amputation, 20 (9%) were dead without amputation and 20 (9%) were dead with amputation. Altogether, 34 (16%) were amputated and 40 (19%) were dead after 1 year. After an average observation period of 3.25 years, 111 (52%) were alive without amputation, 16 (8%) were alive with amputation, 60 (28%) were dead without amputation and 25 (12%) were dead with amputation. A total of 41 (19%) were amputated and 85 (40%) were dead. Fifty complications were registered; 30 (14%) patients had a compartment syndrome, eight (4%) had cerebral stroke and 12 (6%) had a myocardial infarction. Conclusions The results are at least as good as historic controls and similar to international series. Especially, it appears as though the long-term results are somewhat better. The complication rate and morbidity are less than in surgery alone.