{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:56:43Z","timestamp":1790740603316,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T00:00:00Z","timestamp":1536278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vascular"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute limb ischemia is a common vascular emergency requiring immediate intervention. Thrombolysis has been widely utilized for acute limb ischemia; the purpose of this study is to analyze contemporary trends, outcomes and complications of thrombolysis for acute limb ischemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were identified from the Nationwide Inpatient Sample (2003\u20132013) using ICD-9. Patients undergoing emergency thrombolysis for acute limb ischemia were evaluated. Three groups were analyzed: thrombolysis alone, thrombolysis and endovascular procedure (T+ENDO), and failed thrombolysis requiring open surgery (T+OPEN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 162,240 patients with acute limb ischemia were estimated: 33,615 patients (20.7%) underwent thrombolysis as the initial treatment. Mean age was 66.2\u2009\u00b1\u200934.9 years with 54% male. The utilization of thrombolysis increased significantly during the study period (16.8\u201324.2%, p\u2009&lt;\u20090.0001). The most common group was thrombolysis and endovascular procedure (40.7%), followed by thrombolysis alone (34.1%), and T+OPEN (25.2%). Thrombolysis and endovascular procedure increased significantly over time (31.6\u201347.8%, p\u2009&lt;\u20090.0001) whereas thrombolysis alone and T+OPEN significantly decreased (39.6\u201328.6% and 28.7\u201323.6%, respectively, p\u2009&lt;\u20090.0001). Overall mortality was 4.9%; thrombolysis and endovascular procedure compared to thrombolysis alone and T-OPEN had a lower mortality rate (3.2% vs. 6.1% and 5.9%, p\u2009&lt;\u20090001). The overall stroke rate was 1.9%; thrombolysis alone had the highest stroke rate (3.0%, p\u2009&lt;\u20090.0001) with thrombolysis and endovascular procedure the lowest (1.2%) and T+OPEN 1.7%. The highest amputation rate was T+OPEN (11.6%, p\u2009&lt;\u20090.001) compared to thrombolysis and endovascular procedure (5.1%) and thrombolysis alone (5.3%). T+OPEN had the highest incidence of cardiac (5.5%), respiratory (7.3%) and renal complications (12.5%), pneumonia (4.0%), and fasciotomy (16.8%) (all p\u2009&lt;\u20090.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thrombolysis remains an effective treatment for acute limb ischemia with increased utilization over time. There was a significant increase in thrombolysis and endovascular procedure leading to improved outcomes. Thrombolysis alone carried the highest mortality and stroke rate, with T+OPEN associated with the highest amputation and complications. Although thrombolysis is effective, 25% of patients required an open procedure suggesting that patient selection for thrombolysis first instead of open surgery continues to be a clinical challenge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1708538118797782","type":"journal-article","created":{"date-parts":[[2018,9,8]],"date-time":"2018-09-08T02:24:02Z","timestamp":1536373442000},"page":"71-77","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Contemporary trends and outcomes of thrombolytic therapy for acute lower extremity ischemia"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3143-5181","authenticated-orcid":false,"given":"Jonathan","family":"Bath","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor Y","family":"Dombrovskiy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd R","family":"Vogel","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,9,7]]},"reference":[{"key":"bibr1-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.03.244"},{"key":"bibr2-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(05)80036-9"},{"key":"bibr3-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.01.080"},{"key":"bibr4-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.11.017"},{"key":"bibr5-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-948765"},{"key":"bibr6-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.1999.0975"},{"key":"bibr7-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2008.11.010"},{"key":"bibr8-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.01.019"},{"key":"bibr9-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2009.01.003"},{"key":"bibr10-1708538118797782","first-page":"CD002784","volume":"6","author":"Berridge DC","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr11-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.06.109"},{"key":"bibr12-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2017.02.003"},{"key":"bibr13-1708538118797782","unstructured":"Lukasiewicz A, Flisinski P, Lichota W. Catheter directed thrombolysis is not limited to acute limb ischemia treatment \u2013 the experience from vascular surgery division.\n                      J Cardiovasc Surg (Torino)\n                      2017;  54(4)."},{"key":"bibr14-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199804163381603"},{"key":"bibr15-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)70067-8"},{"key":"bibr16-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.112"},{"key":"bibr17-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.09.007"},{"key":"bibr18-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(94)70214-4"},{"key":"bibr19-1708538118797782","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00000658-199409000-00003","volume":"220","author":"The STILE Investigators. Results of a prospective randomized trial evaluating surgery versus thrombolysis for ischemia of the lower extremity","year":"1994","journal-title":"Ann Surg"},{"key":"bibr20-1708538118797782","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S0002-9149(97)00894-1","volume":"81","year":"1998","journal-title":"Am J Cardiol"},{"key":"bibr21-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003543"},{"key":"bibr22-1708538118797782","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.01.053"}],"container-title":["Vascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1708538118797782","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1708538118797782","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1708538118797782","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:31:29Z","timestamp":1777707089000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1708538118797782"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,7]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1177\/1708538118797782"],"URL":"https:\/\/doi.org\/10.1177\/1708538118797782","relation":{},"ISSN":["1708-5381","1708-539X"],"issn-type":[{"value":"1708-5381","type":"print"},{"value":"1708-539X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,7]]}}}