Selective intra-arterial thrombolysis in acute limb ischemia

• Kalinin R.E.
• Klimentova E.A.
• Pshennikov A.S.
• Egorov A.A.
• Suchkov I.A.

Abstract

Despite significant advances in modern treatment of patients with peripheral artery disease, acute limb ischemia remains highly prevalent, limb-threatening, and potentially fatal, continuing to pose a challenge to vascular surgeons. Currently, there are various approaches to managing patients with acute limb ischemia. Selective intra-arterial thrombolysis is an acceptable alternative to surgical treatment. To date, the main indications, advantages and complications of thrombolysis have been identified. Searching for prognostic risk factors for the development of hemorrhagic complications and the likelihood of adverse outcomes after selective intra-arterial thrombolysis can help in choosing a treatment method for patients with this disease. However, despite the introduction of new thrombolytic drugs and improved infusion techniques of selective intra-arterial thrombolysis, the long-term results of vascular patency have not significantly improved and are in fact comparable to those in the urokinase era. Therefore, the prevention of reocclusion by means of additional pharmacological agents is an area that is under development and is being actively studied using numerous approaches, including the use of modern anticoagulant and antiplatelet drugs.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Kalinin R.E., Klimentova E.A., Pshennikov A.S., Egorov A.A., Suchkov I.A.; data collection and handling – Klimentova E.A., Egorov A.A.; draft manuscript preparation – Klimentova E.A.; manuscript revision – Kalinin R.E., Pshennikov A.S., Suchkov I.A

For citation: Kalinin R.E., Klimentova E.A., Pshennikov A.S., Egorov A.A., Suchkov I.A. Selective intra-arterial thrombolysis in acute limb ischemia. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2024; 30 (1): 7–17. DOI: https://doi.org/10.33029/1027-6661-2024-30-1-7-17

Keywords:acute limb ischemia; selective intra-arterial thrombolysis; reocclusion of the vascular wall; thrombotic masses; vascular conduit