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

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 th...

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Bibliographic Details
Main Authors: Hölting, Thomas (Author) , Paetz, Burkhard (Author) , Richter, Götz Martin (Author) , Allenberg, Jens-Rainer (Author)
Format: Article (Journal)
Language:English
Published: 1994
In: The American journal of surgery
Year: 1994, Volume: 168, Issue: 3, Pages: 227-231
ISSN:1879-1883
DOI:10.1016/S0002-9610(05)80191-6
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S0002-9610(05)80191-6
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0002961005801916
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Author Notes:Thomas Hoelting, Burkhard Paetz, Goetz M. Richter, Jens R. Allenberg
Description
Summary: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.
Item Description:Elektronische Reproduktion der Druck-Ausgabe 8. Dezember 2005
Gesehen am 14.09.2023
Physical Description:Online Resource
ISSN:1879-1883
DOI:10.1016/S0002-9610(05)80191-6

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