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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2000 September;19(3):250-254

language: English

Colour duplex sonography-guided local lysis of occlusions in the femoro-popliteal region

Katzenschlager R., Ahmadi A., Atteneder M., Ugurluoglu A., Koppensteiner R., Minar E., Ehringer H.

From the Department of Angiology, University of Vienna, Vienna, Austria


Background. To eval­u­ate ­colour ­duplex son­o­graph­ic guid­ance of local lysis of occlu­sions in the femor­o­pop­li­teal ­region.
Methods. Thirteen con­sec­u­tive ­patients (8 ­female, mean age 67) with periph­er­al ­artery dis­ease with acute and sub­acute occlu­sions in the super­fi­cial femo­ral or pop­li­teal ­artery were includ­ed in this study. The ­lesions were iden­ti­fied by ­colour ­duplex ultra­sound (Acuson 128 XP/10) After ante­ro­grade punc­ture the guide­wire was ­advanced ­through the arte­ri­al ­lesions under B-mode image con­trol. The Mewissen Infusion Catheter and a Katzen infu­sion wire were then accu­rate­ly posi­tioned with­in the ­lesion under B-mode image con­trol. The fibrin­o­lyt­ic drugs were then insert­ed into the occlu­sions, initial­ly 2.5 mg rt-PA as a bolus fol­lowed by Urokinase (50.000 IU/h) for 24 hours. After con­trol ­duplex sonog­ra­phy (over 24 hours) the addi­tion­al angio­plas­ty was per­formed ­either under flu­o­ro­scop­ic or exclu­sive­ly under ultra­sound guid­ance.
Results. Eleven of 13 ­patients with occlu­sions in the femo­ro-pop­li­teal ­region were par­tial­ly recan­al­ised after ultra­sound guid­ed local lysis and after the addi­tion­al angio­plas­ties (nine under flu­o­ro­scop­ic and three under ultra­sound guid­ance) the arter­ies were com­plete­ly recan­al­ised.
Conclusions. Our data show that not only is the posi­tion­ing of the cath­e­ter and the guide­wire for local lysis exclu­sive­ly under ­colour ­duplex guid­ance pos­sible, but also the sur­veil­lance of the local lysis and the addi­tion­al angio­plas­ty. In the case of any com­pli­ca­tions, how­ev­er, easy ­access to angio­gra­phy ­should be pos­sible.

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