{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:21:49Z","timestamp":1791181309993,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":2452,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["K2013-64X-20406-07-3"],"award-info":[{"award-number":["K2013-64X-20406-07-3"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thrombolysis is a common treatment for acute leg ischaemia. The purpose of this study was to evaluate different thrombolytic treatment strategies, and risk factors for complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective analysis of prospective databases from two vascular centres. One centre used a higher dose of heparin and recombinant tissue plasminogen activator (rtPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Some 749 procedures in 644 patients of median age 73 years were studied; 353 (47\u00b71 per cent) of the procedures were done in women. The aetiology of ischaemia was graft occlusion in 38\u00b78 per cent, acute arterial thrombosis in 32\u00b72 per cent, embolus in 22\u00b73 per cent and popliteal aneurysm in 6\u00b77 per cent. Concomitant heparin infusion was used in 63\u00b72 per cent. The mean dose of rtPA administered was 21\u00b70 mg, with a mean duration of 25\u00b72 h. Technical success was achieved in 80\u00b72 per cent. Major amputation and death within 30 days occurred in 13\u00b71 and 4\u00b74 per cent respectively. Bleeding complications occurred in 227 treatments (30\u00b73 per cent). Blood transfusion was needed in 104 (13\u00b79 per cent). Three patients (0\u00b74 per cent of procedures) had intracranial bleeding; all were fatal. Amputation-free survival was 83\u00b76 per cent at 30 days at both centres. In multivariable analysis, preoperative severe ischaemia with motor deficit was the only independent risk factor for major bleeding (odds ratio (OR) 2\u00b798; P &amp;lt;0\u00b7001). Independent risk factors for fasciotomy were severe ischaemia (OR 2\u00b794) and centre (OR 6\u00b750). Embolic occlusion was protective for major amputation at less than 30 days (OR 0\u00b730; P = 0\u00b7003). Independent risk factors for death within 30 days were cerebrovascular disease (OR 3\u00b782) and renal insufficiency (OR 3\u00b786).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both treatment strategies were successful in achieving revascularization with acceptable complication rates. Continuous heparin infusion during intra-arterial thrombolysis appeared to offer no advantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.9579","type":"journal-article","created":{"date-parts":[[2014,6,25]],"date-time":"2014-06-25T09:40:37Z","timestamp":1403689237000},"page":"1105-1112","source":"Crossref","is-referenced-by-count":41,"title":["Outcome and complications after intra-arterial thrombolysis for lower limb ischaemia with or without continuous heparin infusion"],"prefix":"10.1093","volume":"101","author":[{"given":"O","family":"Grip","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Section of Vascular Surgery, Uppsala, and Lund University, Department of Clinical Sciences Malm\u00f6, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Kuoppala","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Centre, Uppsala University, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Acosta","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Centre, Uppsala University, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Wanhainen","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Section of Vascular Surgery, Uppsala, and Lund University, Department of Clinical Sciences Malm\u00f6, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"\u00c5keson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Bj\u00f6rck","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Section of Vascular Surgery, Uppsala, and Lund University, Department of Clinical Sciences Malm\u00f6, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,6,25]]},"reference":[{"key":"2021031210303519900_bjs9579-bib-0001","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.ejvs.2006.09.017","article-title":"Predictors for outcome after open and endovascular repair of ruptured abdominal aortic aneurysms","volume":"33","author":"Acosta","year":"2007","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021031210303519900_bjs9579-bib-0002","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1053\/ejvs.2002.1866","article-title":"Does the wide application of endovascular AAA repair affect the results of open surgery?","volume":"26","author":"Dias","year":"2003","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021031210303519900_bjs9579-bib-0003","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1016\/S0140-6736(05)66628-7","article-title":"Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial","volume":"365","author":"EVAR trial participants","year":"2005","journal-title":"Lancet"},{"key":"2021031210303519900_bjs9579-bib-0004","first-page":"219","article-title":"Thrombolysis in acute limb ischemia","volume":"76","author":"Earnshaw","year":"1994","journal-title":"Ann R Coll Surg Engl"},{"key":"2021031210303519900_bjs9579-bib-0005","first-page":"207","article-title":"Thrombolysis in the management of lower limb peripheral arterial occlusion \u2013 a consensus document","volume":"81","author":"Working Party on Thrombolysis in the Management of Limb Ischemia","year":"1998","journal-title":"Am J Cardiol"},{"issue":"6","key":"2021031210303519900_bjs9579-bib-0006","first-page":"CD002784","article-title":"Robertson I. 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