Thrombolysis during the endovascular treatment of iliac artery occlusions

Abstract

Purpose: The purpose of this study was to assess the possible therapeutic advantage of thrombolysis prior to recanalization of iliac occlusions with percutaneous treatment angioplasty and stenting.

Materials and methods: We retrospectively studied 28 cases of iliac occlusions in 26 patients, occurring over a six-year period. All patients suffered from claudication. Percutaneous treatments were performed using thrombolysis in 25 cases. The average duration of the infusion with urokinase-type plasminogen activator was 28.2 hours (range, 9-48 hours); total dose was 1,820,000 units per hour. The average duration of the follow-up was 46.6 months (range, 2-81 months).

Results: In 21 of 25 cases (84%), we managed to correctly pass through the iliac occlusion using a guidewire and completed the thrombolysis. In all these cases, thrombolysis caused the complete dissolution of thrombi. All 21 cases with complete thrombolytic treatment had complete recanalization of the iliac axis. Twenty of these 21 cases (95%) were than successfully treated with percutaneous methodologies.

Conclusion: Thrombolysis may give an advantage in approaching the percutaneous treatment of atherosclerotic iliac arterial occlusions.