ABSTRACT
The principal goal of thrombolytic therapy is to dissolve intravascular thrombus. Thrombolytic agents are remarkably effective in accomplishing this goal, and they can do so in a minimally invasive fashion. Through percutaneous means alone, recanalization of an occluded bypass graft or artery can be achieved within a few hours and the thrombus can be completely dissolved over the course of 12 to 48 hours (1). Culprit stenotic lesions become readily apparent after successful thrombolytic therapy, lesions that must be addressed to diminish the risk of reocclusion (2). The unmasked lesions can frequently be repaired percutaneously. Even when open surgical revascularization is necessary, it can oftentimes be performed on an elective basis after ample time for patient preparation. Thrombolytic therapy can be employed to clear thrombus from small vessels that are inaccessible to standard balloon catheter thrombectomy, sometimes identifying target vessels for an operative bypass procedure (Fig. 1) (3). Clinical trials have proven thrombolytic therapy to be effective for the treatment of acute arterial occlusion, resulting in a reduction in mortality, limb loss, length of hospital stay, and the need for open surgical intervention (4-7).
