الفهرس 
Introduction and ObjectivesOnly 14 pages are availabe for public view
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Abstract
Objectives: acute thrombotic ischemia is a very dangerous, limb threatening and life threatening disease. It is better treated by catheter directed thrombolysis. Now, tissue plasminogen activator (tPA) like actilyse is safer than streptokinase or urokinase. The current study is designed to show its efficacy and safety and to investigate variables that correlate with outcome. Methodology: It is a prospective cohort study. It included patients with acute thrombotic limb occlusion. Excluded ones were acute ischemia due to embolism, trauma, arterial dissection, complicated aneurysm, bleeding risk, history of recent intracranial bleeding, massive gangrene beyond salvage, uncontrolled hypertension. The study is approved by ethical committee of Beni Suef University and assigned number FWA00015574. A written consent was obtained. Primary end points were technical success, clinical success and limb salvage. Secondary end points were procedural complications. Patient’s variables were determined and statistical analysis was done to show correlation between study variables and outcome. Results: 36 patients were enrolled in the study from March 2019 to February 2021 in Beni Suef University hospital. It included 21 male patients (58.33%) and 15 female patients (41.67%). The patient’s mean age was 58.42 years. The patient’s mean BMI was 31.56. Risk factors were distributed as the following: smoking in 15 patients (41.67%), diabetes mellitus in 16 patients (44.44%), hypertension in 15 patients (41.67%), ischemic heart disease in 9 patients (25%) and hyperlipidemia in 14 patients (38.89%). Clinical presentation showed that 16 patients were in Rutherford IIa category (44.44%) and 20 patients were in Rutherford IIb category (55.56%). Limb salvage was achieved in 14/16 of patients in Rutherford IIa category (87.5%) and 12/20 (60%) of patients in Rutherford IIb category. Statistical analysis showed correlation of body mass index and severity of ischemia to outcome. Also, the frequency of risk factors in a single patient is correlated to outcome. Conclusion: catheter directed thrombolysis using actilyse is effective and safe to treat acute thrombotic limb ischemia. Its outcome is better with lower body mass index, less severe clinical presentation and less or no comorbid disease.
Keywords: catheter directed thrombolysis, acute ischemia.