Study On Application Of Catheter-directed Thrombolysis In Chronic Limb Ischemia Disease

Objective To evaluate the efficacy and safety of catheter-directed thrombolysis together with percutaneous transluminal angioplasty in treating chronic critical limb ischemia disease of lower extremitie.Methods Clinical data were reviewed on 36 patients of chronic limb ischemia disease treated by endovascular therapy from March 2013 to November 2014。All 36 patients had a history of chronic ischemia of lower limb(2-20 months),A1 l patients complained of intermittent claudication with a mean distance of 84 m(20—150 m)。In 17 patients.catheter—directed thrombolysis was initially carried out,which was followed by endovascular angioplasty balloon dilatation or stent placement.The other 19 patients were treated by upfront endovascular angioplasty balloon dilatation or stent placement.Results In the thrombolysis group,the occluded length of the artery before and after thrombolysis was(136.8±22.9)mm and(115.4±17.8)mm(t=11.9,P<0.05),which has a significant difference。The ABI of limb before and after thrombolysis was(0.26±0.13) and(0.32±0.12)(t=-0.46,P<0.05)。The number of stents used in thrombolysis group was lower than endovascular angioplasty group[(1.6±0.8)VS(2.1±0.7),t=2.1,P<0.05],the same as the length of stents used[(117.6±33.1)mm,(142.1±29.7)mm,t=2.3,P<0.05]。All of 36 patients were followed up,there were no significant difference in primary patency rate between thrombolysis group and endovascular angioplasty group[(72.7% vs 66.7%)and(70.6% vs 63.2%),P>0.05].The difference of complications between two groups(thrombolysis group 6 vs stent group 5,P>0.05) has no statistical significance.Conclusion Catheter-directed thrombolysis together with assisted endovascular angioplasty is an effective and safe treatment for chronic critical limb ischemia disease of lower extremitie,which can reduce the length of arterial occlusion and stents。...