[Ultra-high dose streptokinase in treatment of arterial occlusions of leg arteries in advanced age].

Abstract

In a retrospective study, the data of 218 patients (age 65-91) with obstructions of leg-arteries were evaluated, who underwent short-term ultrahigh fibrinolytic treatment. Some of the patients were also treated with percutaneous transluminal angioplasty after fibrinolysis. The overall patency-rate was 69 percent in the younger age group (65-74 years) and 46 percent in the group aged > or = 75. It could be shown, however, that the patency-rate was affected positively by concomitant factors (especially at least two patent calf arteries). These factors were less frequently found in the older age group, resulting in a lower patency-rate. Most likely the underlying reason is not age per se, because it could be shown, that the reason, which led to fibrinolytic treatment changed with age: In the younger age-group, Fontaine-stage II led to treatment in the vast majority of cases (71%). There was a shift to stage III (26%) and IV (27%) in the group > or = 75 years. This progression of artery disease usually leads to a reduced success rate of fibrinolytic treatment, because adverse concomitant factors prevail.