Peripheral Intra Arterial Thrombolysis

Cannulate the vessel and pass a guide wire across the thrombus before thrombolysis.

Heparin is given intravenously as soon as the guide wire passes the thrombus.

Heparin bolus of 70 units per / kg followed by infusion of 1000 units / hour (maintain APTT 1.5 to 2.5 times control).

Catheter with multiple side holes used for thrombolysis.

Streptokinase is not generally used in view of bleeding complications.

Either Urokinase or tPA (tissue type plasminogen activator) is used.

Immediate success 60-90%.

2 year patency upto 80%.

Complications of Peripheral Intra Arterial Thrombolysis

Most common complication: 3 -20% site bleed.

Intracranial bleeds can occur in 0.5 – 2%.

8% may develop myocardial infarction.

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