Thrombolysis of Occluded Femoropopliteal Graft with Locally Delivered Human Plasmin

Abstract

Introduction Acute lower limb ischemia results from thrombosis or embolization of diseased native artery or previously implanted bypass graft. When this occurs, several options are available to restore blood flow: catheter-directed thrombolysis, mechanical thrombectomy or open surgery. Fundamental reasons to apply percutaneous interventions are avoiding open procedures in high risk patients, and avoiding difficult dissection through scar tissue.

Case Outline A 67-year-old male was admitted at our Institution for critical limb ischemia. After performed angiography the diagnosis of occluded femoropopliteal graft was established. Occlusion was resolved by catheter-directed thrombolysis with plasmin. Culprit lesions were treated by angioplasty.

Conclusion Our patient underwent a successful thrombolysis of occluded femoropopliteal graft with locally-delivered human plasmin.

Keywords: percutaneous intervention; catheter-directed thrombolysis; human plasmin; femoropopliteal bypass