Turk Kardiyol Dern Ars. 2007; 35(2): 101-104

Successful slow-dose infusion of thrombolytic therapy in a patient with stent thrombosis in the left common iliac artery

Barış Kılıçaslan, Fahriye Vatansever, Cem Nazlı, Oktay Ergene
Ataturk Research And Treatment Hospital, Cardiology Department, Izmir

Subacute thrombosis of the peripheral stents is a rare but serious complication. A 55-year-old-man presented with a complaint of claudication in the left lower extremity of a two-year history. A weak left femoral artery pulse was elicited, but pulses in the left popliteal artery, tibialis anterior artery, and dorsalis pedis artery were absent. Upon detection of a critical stenosis (90%) in the mid portion of the left common iliac artery by peripheral arteriography, a self-expandable stent was implanted in the stenotic region. Four weeks after the procedure, he presented with severe pain in his left leg. Peripheral arteriography revealed total occlusion of the left main iliac artery due to stent thrombosis. Thrombolytic therapy with streptokinase was administered with a bolus dose of 250,000 IU followed by a slow infusion of 100,000 IU/hour for 24 hours. Angiography performed three days after the thrombolytic infusion demonstrated a patent left common iliac artery with no residual stenosis. To our knowledge, the use of a slow-infusion regime of thrombolytic therapy has not been reported previously.

Keywords: Atherosclerosis, femoral artery/pathology, iliac artery/ pathology, intermittent claudication; peripheral vascular diseases; streptokinase/therapeutic use; thrombolytic therapy/methods

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