Relevant bibliographies by topics / Hepatic artery stenosis

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  1. Journal articles
  2. Dissertations / Theses
  3. Book chapters
  4. Conference papers

Academic literature on the topic 'Hepatic artery stenosis'

Author: Grafiati
Published: 4 June 2021
Last updated: 13 February 2022

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Journal articles on the topic "Hepatic artery stenosis"

1

Bluth, Edward I., Richard Tupler, and Neil Lall. "Hepatic Artery Stenosis after Liver Transplantation." Radiology 263, no. 1 (April 2012): 308–9. http://dx.doi.org/10.1148/radiol.12112185.

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Simoes, Joana S., Bethan Davies, Shirish R. Sangle, Rachel J. Davies, and David P. D’Cruz. "Hepatic Artery Stenosis in Antiphospholipid Syndrome." Clinical and Applied Thrombosis/Hemostasis 18, no. 4 (December 26, 2011): 432–33. http://dx.doi.org/10.1177/1076029611430957.

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Yilmaz, Saim, Kağan Çeken, Alihan Gürkan, Okan Erdoğan, Alper Demirbaş, Adnan Kabaalioğlu, Timur Sindel, and Ersin Lüleci. "Endovascular Treatment of a Recipient Celiac Trunk Stenosis after Orthotopic Liver Transplantation." Journal of Endovascular Therapy 10, no. 2 (April 2003): 376–80. http://dx.doi.org/10.1177/152660280301000234.

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Purpose: To present the successful endovascular treatment of a severe recipient celiac trunk stenosis that led to allograft ischemia following liver transplantation. Case Report: A 56-year-old woman underwent orthotopic liver transplantation because of hepatitis C—induced cirrhosis. After the operation, routine hepatic Doppler ultrasonography showed a tardus parvus flow pattern in the hepatic artery, suggesting an impending hepatic artery thrombosis. Digital subtraction angiography (DSA), however, showed severe stenosis of the recipient celiac trunk and moderate splenic artery steal. The stenosis was dilated and stented in the same session. The postprocedural DSA showed good dilation of the lesion with immediate improvement of hepatic opacification. Follow-up Doppler ultrasound scans showed normal flow patterns in the hepatic artery at 3 and 6 months. Conclusions: In the presence of a tardus parvus flow pattern on Doppler ultrasound after liver transplantation, the possibility of an undetected recipient celiac stenosis should be considered in the differential diagnosis. Such lesions can successfully be treated with angioplasty and stenting.
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Papadimitriou, Pitoulias, Tachtsi, Aslanidou, Lazaridis, and Alexandrakis. "Celiac artery aneurysm associated with atherosclerotic common hepatic artery stenosis." Vasa 34, no. 2 (May 1, 2005): 136–39. http://dx.doi.org/10.1024/0301-1526.34.2.136.

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Celiac artery aneurysms are rare vascular lesions and represent 4% of all splanchnic aneurysms. Media degeneration and atherosclerosis are the most common underlying etiologic factors. The risk of rupture and the associated mortality rate are 13% and 40% respectively. In contrast, elective repair carries a low mortality rate of 5%. Most of celiac artery aneurysms are asymptomatic and in the past nearly 80% of the cases were diagnosed when ruptured. Recently, there is an increased recognition of all splanchnic aneurysm types, probably because of better diagnostic techniques. We report a case of celiac artery aneurysm with severe atherosclerotic stenosis of the common hepatic artery. We performed, through a midline supraumbilical laparotomy, extended partial aneurysmectomy and common hepatic artery ostium endarterectomy. For the closure we used Dacron patch. The uncomplicated postoperative patient’s course, with no evidence of liver dysfunction and excellent patency of the common hepatic artery, suggests that this technique offered good results and minimized the perioperative risk.
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Sandow, Tyler A., Edward I. Bluth, Neil U. Lall, Qingyang Luo, and W. Charles Sternbergh. "Doppler Characteristics of Recurrent Hepatic Artery Stenosis." Journal of Ultrasound in Medicine 36, no. 1 (December 2, 2016): 209–16. http://dx.doi.org/10.7863/ultra.16.02014.

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6

Molvar, Christopher, Ross Ogilvie, Deep Aggarwal, and Marc Borge. "Transplant Hepatic Artery Stenosis: Endovascular Treatment and Complications." Seminars in Interventional Radiology 36, no. 02 (May 22, 2019): 084–90. http://dx.doi.org/10.1055/s-0039-1688420.

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AbstractHepatic artery stenosis (HAS) is an infrequent complication of liver transplant; if left untreated, it can lead to hepatic artery thrombosis with high risk of biliary necrosis and graft loss. HAS is diagnosed with screening Doppler ultrasound, together with computed tomography angiography and magnetic resonance angiography. Endovascular treatment with angioplasty ± stent placement is safe and effective with infrequent major complications; however, when complications occur, they can devastate long-term graft survival. Herein, we present two cases of HAS treated with balloon angioplasty with resultant major complications requiring operative intervention.
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Boraschi, P., F. Donati, M. C. Cossu, R. Gigoni, C. Vignali, F. Filipponi, C. Bartolozzi, and F. Falaschi. "Multi-detector computed tomography angiography of the hepatic artery in liver transplant recipients." Acta Radiologica 46, no. 5 (August 2005): 455–61. http://dx.doi.org/10.1080/02841850510021724.

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Purpose: To evaluate the ability of multi-detector row computed tomography angiography (CTA) in detecting hepatic artery complications in the follow-up of liver transplant patients, performing volume-rendering as reconstruction technique. Material and Methods: The anatomy of hepatic artery was studied in 27 liver transplant recipients with a four-row CT scanner using the following parameters: collimation, 1 mm; slice width, 1 mm; table feed, 6–8 mm/s; spiral reconstruction time, 0.5 s; reconstruction interval, 0.5 mm; mAs, 160; kVp, 120. Before the study, the patients received 1000 ml of water as oral contrast agent to produce negative contrast in the stomach and the small bowel. A non-ionic contrast medium was infused intravenously at a rate of 5 ml/s with a bolus tracking system. Volume-rendering of hepatic artery was performed with the 3D Virtuoso software. Results: The celiac trunk, the hepatic artery, and the right and left hepatic arteries were successfully displayed in high detail in all patients. Side branches, including small collaterals, and hepatic artery anastomosis could also be readily visualized. Volume-rendered CTA detected six hepatic artery stenoses, two hepatic artery thromboses, and two intrahepatic pseudoaneurysms. In two cases, CT detected hepatic artery stenosis with a diameter reduction of less than 50%, while digital subtraction angiography showed a normal artery. Conclusion: Volume-rendered multi-detector CTA is a promising non-invasive technique, since it allows images of high quality to be generated with excellent anatomical visualization of the hepatic artery and its complications in liver transplant recipients.
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Naidu, Sailendra, Sadeer Alzubaidi, Grace Knuttinen, Indravadan Patel, Andrew Fleck, John Sweeney, Bashar Aqel, et al. "Treatment of Hepatic Artery Stenosis in Liver Transplant Patients Using Drug-Eluting versus Bare-Metal Stents." Journal of Clinical Medicine 10, no. 3 (January 20, 2021): 380. http://dx.doi.org/10.3390/jcm10030380.

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Hepatic artery stenosis after liver transplant is often treated with endovascular stent placement. Our institution has adopted use of drug-eluting stents, particularly in small-caliber arteries. We aimed to compare patency rates of drug-eluting stents vs. traditional bare-metal stents. This was a single-institution, retrospective study of liver transplant hepatic artery stenosis treated with stents. Primary patency was defined as time from stent placement to resistive index on Doppler ultrasonography (<0.5), hepatic artery thrombosis, or any intervention including surgery. Fifty-two patients were treated with stents (31 men; mean age, 57 years): 15, drug-eluting stents; 37, bare-metal stents. Mean arterial diameters were 4.1 mm and 5.1 mm, respectively. Technical success was 100% (52/52). At 6 months, 1, 2, and 3 years, primary patency for drug-eluting stents was 80%, 71%, 71%, and 71%; bare-metal stents: 76%, 65%, 53%, and 46% (p = 0.41). Primary patency for small-caliber arteries (3.5–4.5 mm) with drug-eluting stents was 93%, 75%, 75%, and 75%; bare-metal stents: 60%, 60%, 50%, and 38% (p = 0.19). Overall survival was 100%, 100%, 94%, and 91%. Graft survival was 100%, 98%, 96%, and 90%. Stenting for hepatic artery stenosis was safe and effective. While not statistically significant, patency improved with drug-eluting stents compared with bare-metal stents, especially in arteries < 4.5 mm in diameter. Drug-eluting stents can be considered for liver transplant hepatic artery stenosis, particularly in small-caliber arteries.
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9

Ursini, G., A. Ferrara, S. Caruso, G. Ferrari, M. L. Boella, and R. M. Ferrara. "P.07.4 HEPATIC ARTERY ABERRATION WITH BILIARY STENOSIS." Digestive and Liver Disease 46 (March 2014): S80. http://dx.doi.org/10.1016/s1590-8658(14)60234-6.

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Chamarthy, Murthy R., Terence W. Hughes, Mohit Gupta, Josephina A. Vossen, Noel B. Velasco, and Kenneth M. Zinn. "Celiac Artery Stenting to Facilitate Hepatic Yttrium-90 Radioembolization Therapy." Case Reports in Radiology 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/236732.

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Radioembolization offers a novel way to treat the nonresectable, liver predominant hepatic malignancies with better tumor response and overall progression-free survival rates. Transarterial catheter-based radioembolization procedure involves the hepatic arterial administration of glass- or resin-based beta emitting Yttirum-90 microspheres. Safe delivery of the tumoricidal radiation dose requires careful angiogram planning and coil embolization to quantify lung shunting and prevent systemic toxicity, respectively. Diagnostic pretreatment angiogram also serves to identify the hepatic arterial variant anatomy and other coexisting pathologies that might require a different or alternative approach. We describe a complex case of celiac artery stenosis with tortuous pancreaticoduodenal arterial arcade precluding access to the right hepatic artery for performing radioembolization. Celiac artery stenting of the stenosis was performed to facilitate subsequent safe and successful Yttrium-90 microsphere radioembolization.
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Dissertations / Theses on the topic "Hepatic artery stenosis"

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Laštovičková, Jarmila. "Úloha zobrazovacích metod a intervenční radiologie v programu transplantace jater: transarteriální chemoembolizace hepatocelulárního karcinomu a terapie cévních a biliárních komplikací po ortotopické transplantaci jater." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-327213.

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121 9. Summárý Purpose: This study was designed to evaluate the role of interventional radiology in liver transplantation programme. The aim is to present our experience, technical outcomes and long-term clinical results with chemoembolization of hepatocellular carcinoma in patients before liver transplantation and with percutaneous treatment of vascular and biliary complication after orthotopic liver transplantation. Methods: Twenty five patients (17 men, 8 women, mean age 57.76 years) with HCC were scheduled for TACE prior to liver transplantation from 2008 to 2012. Twenty three procedures were performed, 7 c-TACE in 2008 and 16 DEB TACE in next years. Thirty patients (13 men, 17 women, mean age 46.4 years) with biliary strictures after liver transplantation without endoscopic access possibility were treated with balloon dilatation and biliary duct drainage from 1996 and 2010. Twenty patients (13 men, 7 women, mean age 45.25 years) were treated with PTA/stent due to hepatic artery stenosis after liver transplantation between 1996 and 2011. Stents were placed to the hepatic/celiac artery in 16 PTAs, balloon dilatation alone was performed in 7 stenosis due to tortuosity of the vessel. Results: Liver transplantation was performed to 20 patients after TACE. Only one patient (4.5 %) was excluded from waiting...
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Book chapters on the topic "Hepatic artery stenosis"

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"Hepatic Artery Stenosis." In High-Yield Imaging: Interventional, 143–45. Elsevier, 2010. http://dx.doi.org/10.1016/b978-1-4160-6160-1.00042-9.

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"Liver Transplant Hepatic Artery Stenosis/Thrombosis." In Diagnostic Ultrasound: Abdomen and Pelvis, 274. Elsevier, 2016. http://dx.doi.org/10.1016/b978-0-323-37643-3.50051-7.

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Conference papers on the topic "Hepatic artery stenosis"

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Qazi, Shahbaz Ahmed, Muhammad Al Moiqel, Omar Bashir, Muhammad Arabi, and Muhammad Saeed. "Hepatic Artery Stenosis in Liver Transplant Recipient’s Angioplasty and Stenting a Single Center Experience." In PAIRS Annual Meeting. Thieme Medical and Scientific Publishers Pvt. Ltd., 2019. http://dx.doi.org/10.1055/s-0041-1730615.

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Falk, E. A. "UNSTABLE ANGINA PECTORIS: PATHOLOGIC ASPECTS." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643711.

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Unstable angina pectoris represents a common and important manifestation of acute ischemic heart disease encompassing the broad spectrum of clinical syndromes between stable effort angina and acute myocardial infarction. This group of patientsisfar from uniform concerning underlying pathogenetic mechanisms and prognosis, but generally the risk of infarction or deathis increased during the unstable period. Most patients are presenting with new or worsening effort angina or angina at rest,and especially patients with rest anginaassociated with transient ECG changes seem to constitute a high risk subgroup. Transient reductions in coronary blood flow,rather than increases in myocardial oxygen demand, seem to play the major role in rest angina, indicating an underlying 'dynamic' coronary stenosis.Furthermore, unstable angina seems to beagood clinicalmarker for actively progressing coronary-artery disease.Pathologically, a rapidly evolving coronary-artery lesion represented by a disrupted atherosclerotic plaque with variable degree of plaque hemorrhage and luminalthrombosis usually is present in patientscoming to autopsy after a period of rest angina. The thrombus at the rupture site may be mural and limited (just sealing therupture) or occlusive depending on the degree of preexisting atherosclerotic stenosis. An occlusive thrombus is seldom seen over ruptured plaques causing less tha15% stenosis (histologic area stenosis), but is found with increasing frequency when stenosis severety increases beyond 15%.Most occlusive thrombi have a layered structure with thrombus material of differing age indicating an episodic growth by repeated mural deposits. Aggregated platelets usually can be identified in the mostrecent part of the thrombus, while older parts are more homogeneous due to fibrin infiltration/stabilization. Additionally,microemboli and microinfarcts are frequently found in the myocardium downstream tocoronary thrombi. So, the period of unstable angina preceding a fatal heart attackseems to be characterized by an ongoing thrombotic process in a major coronary artery where recurrent mural thrombus formation alternates with intermittent thrombus fragmentation and peripheral embolization. Such a dynamic thrombosis (with or without a concomitant focal vasospastic phenomenon) at the site of an unstable (ruptured) atherosclerotic lesion obviously may lead to the other clearly thrombus-related acute ischemic events: myocardial infarction or sudden death.Clinical studies using coronary angiography and coronary angioscopy during the acute phase of unstable angina have revealed a high frequency of ulcerated (unstable) atherothrombotic lesion in arteries responsible for the acute ischemia. Furthermore, episodic platelet activation (usually associated with chest pain) has recently been demonstrated in patients with unstable angina.The mechanism underlying pain/ischemia(predominantly spasm?) and the rapid plaque progression (plaque hemorr.hage/luminal thrombosis?) during unstable angina maydiffer. Accordingly, therapy directed against a possible spasm (nitrates, calcium antagonists) usually relieves pain effectively without having any documented effect on infarction/survival, while antithr-ombotic therapy (aspirin, heparin) clearlyimproves the prognosis without apparent antianginal effect. Therefore, with the objective not only of relieving pain but also of improving the prognosis, more attention should be paid to the potentially fatal thrombotic process that apparently isgoing on in a major coronary artery of many patients with unstable angina.
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Prosdocimi, M., M. Finesso, and A. Zatta. "A DOG MODEL OF PERIPHERAL ARTERIAL THROMBOSIS: POSSIBLE PHARMACOLOGICAL CONTROL OF VASCULAR OCCLUSION IN A STENOTIZED FEMORAL ARTERY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643185.

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It has been described by several authors that a critical stenosis of a dog coronary artery causes cyclical blood flow variations (CBFV), which are caused by platelet plugging of the vessel. Little information is available on the mechanism of thrombus formation in a stenotized peripheral artery and on the pharmacological control of this phenomenon. Male beagle dogs were anesthetized with sodium pentobarbital, artificially ventilated and prepared for the recording of arterial pressure, heart rate and femoral blood flow. A cylinder of Lexan with internal diameter of 1.6-1.8 mm and a length of 2.0 mm was placed on the femoral artery near the flow probe. This procedure induced CBFV in about 15% of the experiments. If the arterial vessel was previously squeezed with a forcep at the site of stenosis, CBFV were present in 100% of the experiments. Femoral flow at its peak averaged about 30% of control flow and was characterized by a gradual decrease followed by spontaneous abrupt restorations. CBFV were rather constant for at least two hours in dogs without pharmacological treatment thus allowing, by measuring the changes in frequency and severity of CBFV, the evaluation of a drug action on thrombus formation after its intravenous administration. Heparin (50 I.U.Ag) was ineffective while ASA (20 mgAg) reduced or prevented CBFV in about 50% of the experiments. CBEV were always completely prevented by an inhibitor of thromboxane synthetase (UK 38485, 0.5 mgAg) r by chloropromazine (0.5 mgAg) and by a serotonin antagonist (ke-tanserin, 0.5 mgAg). On the other hand, dipyridamole (1.0 mgAg) and an alpha 1 antagonist (prazosin, 0.1 mgAg) were not effective. These results are quite similar to those previously reported in the coronary model of CBFV. They suggest some similarity between the process of thrombotic occlusion in different arterial districts and emphasize the importance of thronboxane and serotonin in this particular model of vascular occlusion. Moreover, the striking increase in the percentage of animal showing CBFV after vessel damage is in keeping with the view that vessel wall properties are essential modulators in the process of arterial thrombosis.
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Bel Lakhal, N., J. M. Pernes, D. Lichtenstein, M. Roncato, J. C. Gaux, W. Nieuwenhuizen, and M. Aiach. "MODIFICATION OF COAGULATION AND FIBRINOLYSIS DURING TRANSLUMINAL ANGIOPLASTY IN PATIENTS RECEIVING HEPARIN OR PENTOSAN POLYSULFATE (HEMOCLAR)." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643247.

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Twenty patients with high stenosis of iliac or femoral artery were randomely allocated to receive by intra arterial route (IA) either 5,000 IU heparin or 50 mg Hemoclar immediately before starting the angioplasty. Those receiving Hemoclar were given a second IA 50 mg bolus at the end of the dilatation.Two blood samples were obtained by venous punction 1) after an initial 30 min resting (V1), 2) at the end of the procedure (V2)- Arterial punction by the dilatation catheter was also performed immediately before and after the dilatation leading to two other samples A1 and A2 The coagulation studies include activated partial thromboplastin time (APTT), thrombin time (TT), hep test (Hemachem, St-Louis, USA), anti Xa activity (Stachrom heparin, Diagnostica-Stago Asnieres, France). There was a significant increase in APTT, TT, and hep test between A1 and A2 as well as V1 and V2 in both groups of patients. However, the prolongation was significantly higher for heparin. Anti Xa activity significantly increased only in heparin group.Fibrinolysis was studied by measuring tPA by the SOFIA assay described by Angles-Cano (Anal. Biochem. 1985, 153, 201), euglobulin lysis time (ELT) and a new plasma ELISA assay specific for fibrinogen degradation products (FDPs) using monoclonal antibody described at the Gaubius Institute (Blood 1985, 66, 503). A significant increase in tPA was observed during the dilatation (A2/A1) and V2/V1) only in the patients receiving Hemoclar. The slight increase of the fibrinolytic activity was further corroborated by a significant increase in FDPs (A2/A1). In both groups, but only in the venous samples (V2/V1), ELT was shortened (p<0.05) and fibrinogen was decreased (p<0.05)No thrombotic complications were observed during the procedure in both groupsConclusion: This study confirms that Hemoclar has an inhibiting effect on coagulation by inhibiting thrombin and thrombin generation, but no anti Xa activity. However, the anticoagulant potency is much reduced when compared to heparin. The profibrinolytic effect seems to be related to the release of free tPA.
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Barbash, G. I., H. Hod, H. I. Miller, A. Roth, S. Rath, Y. Har Zahav, B. Rabinovitz, S. Laniado, and U. Seligsohn. "THE ISRAELI STUDY OF EARLY INTERVENTION IN MYOCARDIAL INFARCTION; INTRAVENOUS RT-PA WITH SUBSEQUENT REVASCULARIZATION." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643745.

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Immediate mechanical revascularization forlarge population of acute myocardial infarction (AMI) patients, is logistically impractical. Effectiveness of early intravenous rt-PA,and feasibility of delaying the coronary angioplasty were studied. 57 AMI patients were enrolled since October 1986; 30 via Emergency ward, and 27 via mobile intensive care unit. The mean time interval from onset of ischemic pain to rt-PA bolus was 115+52 min.The protocol included an initial 10 mg rt-PA bolus followed by continuous infusion of 110 mg over 6 hr, concomitant continuous heparin and lidocain infusion, and aspirin 250 mg/day; coronary catheterization after 72 hr. and angioplasty of suitable infarct-related artery (IRA). 49 patients (86%) had clinical signs of reperfusion (disappearance of chest pain with resolution of ST elevation) within 60 min. The 8 "non-responders" were treated earlier (shorter time interval from onset of painto rt-PA bolus) than the "responders"(87+37 and 120+53 min respectively,p=0.01). Of "responding" patients, 5 had intermittant reocclusion-reperfu-sion cycles, and an additional 4 reoccluded silently before coronary catheterization (7 to 72 hr).29 PTCA successful procedures(53% of pats) of the infarct-related artery (IRA) were performed: 25 during the protocol catheterizationat 72 hr, and 4 which were performed as an emergency procedure of high grade stenosis (1),or totally occluded IRA (3), in 4 of the 8 "non-responders".There were 3 emergency and 8 elective bypass operations (20%). While in the 25 patients with anterior wallinfarction the admission Lt. ventricular ejection fraction (LVEF) (37+12%) improved (46+17%) at discharge, in the 30 patients with inferior wall infarction the admission and discharge LVEF were both normal.Two patients expired; one within minutes after treatment initiation, and the other following no response to the thrombolytic therapy and reocclusions of repeat coronary dilatations. These results indicate that rt-PA thrombolysis is a safe treatment modality enabling planning of deferred mechanical revascularization under more optimal conditions.
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Verhaeghe, R., G. Wilms, P. Mombaerts, J. Vermylen, A. Baert, and M. Verstraete. "FEMORO-POPLITEAL ARTERY THROMBOLYSIS WITH INTRA-ARTERIAL INFUSION OF RECOMBINANT TISSUE-TYPE PLASMINOGEN ACTIVATOR (rt-PA)." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643892.

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The efficacy and tolerance of intra-arterial rt-PA infusion was tested in 27 patients with a thrombotic occlusion of the femoro-popliteal artery. The mean length of the occluding thrombus was 10 cm (range : 2-25 cm). The occlusion was recent (<1 week old) in 7 patients; in 2 it existed for more than 6 months. The rt-PA solution was infused through an angiographic catheter embedded into the thrombus at a rate of 10 mg/hr in the first 11 patients, 5 mg/hr in the next 11 and 3 mg/hr in the last 5. The maximal dose foreseen in the protocol was 50 mg; the mean dose infused was 42 mg. Heparin (400 IU/hr) was infused concomitantly. Thrombolysis occurred in all 27 patients. Angiographic restoration of patency was obtained in 25 (93%); it first appeared after a mean dose of 27 mg rt-PA (range : 10 to 50 mg). In 21 patients, a percutaneous transluminal angioplasty was needed to dilate a residual stenotic lesion or remaining mural thrombi. This secondary procedure initiated reocclusion in 2 patients by causing a distal embolus and a subintimal dissection, respectively. Early rethrombosis occurred spontaneously in 3 other patients. Thus, 20 (74%) patients had a clinical improvement at discharge from the hospital.rt-PA infusion was complicated by bleeding in 10 (37%) patients: a groin hematoma at the catheter entry site occurred in 9 patients, a hematoma from a previous venous in 2 and gingival oozing in 3. None required blood transfusion. Premature interruption of the infusion because of local hematoma formation was the cause of failure in one patient.This pilot trial confirms the feasibility of thrombolysis with local infusion of rt-PA in peripheral arterial thrombosis. The early clinical results and the incidence of bleeding complications appear similar to those observed with local low-dose streptokinase, although initial patency seems easier to restore with rt-PA. A prospective trial comparing rt-PA to streptokinase in this condition is thus warranted
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