Local longtime lysis in combination with percutaneous transluminal angioplasty (TPA).
In order to produce an endogenous lysis in case of local longtime lysis Urokinase is infused directly into the occlusion in a maximum dosage of 40,000 U/h via an arterial catheter. Remaining stenoses are extended by means of a dilatation catheter. The so far obtained results concerning 72 patients with very long and/or very old arterial occlusions show a primary success-rate of 96% and a 2 years' patency rate of 85% for all patients with a primary success of treatment. Complications and side-effects are scarce with this method. Therefore it can be applied with patients for whom other recanalising catheter methods are not indicated and with whom vascular surgery is not possible. However, a lasting success of treatment is only to be expected on the basis of the precise planning and careful performance of a long-term after treatment.