Assesssment of the role of Thrombolytic Therapy by Using Catheter in the Treatment of Acute Lower Limb Ischemia

Background: Acute limb ischemia is characterized by an abrupt reduction in perfusion to the affected limb, posing a risk to the condition's viability and necessitating prompt revascularization. Aim and objectives: To assess the efficacy, safety, and complications of catheter-directed thrombolysis (CDT) in acute lower limb ischemia. Patients and methods: This prospective interventional study includes 30 patients selected from attendees of outpatient Vascular Surgery clinics of Al Azhar University Hospitals. Samples were collected using a random systematic method. Results: Mean Hemoglobin g/dl was 12.78 ± 1.57. The mean Leucocyte count /microliters was 7015.07 ± 448.49. The mean platelet count *1000/microliter was 250.83 ± 22.11. The mean Ptt (sec) was 30.13 ± 2.13. The mean INR was 1.03 ± 0.09. 22 (73.3%) patients had Category IIa. 8 (26.67%) patients had Category I. 26 (86.67%) patients had Detectable Runoff vessels. 4 (13.3%) patients had No detectable Runoff vessels.7 (23.3%) patients had Peri-sheath hematoma. 4 (13.3%) patients had Hematuria. 2 (6.67%) patients had Epistaxis. 1 (3.3%) patient had Compartmental syndrome. 2 (6.67%) patients had Balloon angioplasty. 2 (6.67%) patients had Thrombectomy. 1 (3.3%) patient had Bypass. 1 (3. 3%) patient had Fasciotomy. 1 (3.3%) patient had BKA. 5 (16.67%) patients had AKA.25 (83.3%) patients had successful thrombolysis. 5 (16.67%) patients had failed thrombolysis. Conclusion: In the management of acutely ischemic limbs, CDT is a viable, risk-free, and minimally invasive substitute for surgical intervention. Nevertheless, bleeding and hematoma complications are a significant problem of this treatment.