ABSTRACT
Peripheral arterial thrombolysis (PAT) is an important technique in the management of acute
limb ischemia. Like many techniques, the interest in PAT was strong in the 10 years after its
introduction and a large amount of literature was generated during the 1990s. Since 2000, the
focus of the literature on thrombolysis has been concentrated on the investigation of new lytic
agents and alternative applications of PAT. There has been a general decline in the use of PAT in
the management of acute limb ischemia, resulting from evidence-based practice limiting it to
limb-threatening ischemia in younger patients. Its present role is primarily in the management
of acute limb-threatening ischemia where temporal constraints allow, usually Rutherford 2A
and selected 2B ischemia, often as a prelude to subsequent angioplasty or surgery (Table 1).
