Five cases, representative of our larger series, are described in which grafts and lower extremities of patients with peripheral arterial occlusions were salvaged by thrombolytic therapy with catheter-directed intra-arterial urokinase. These patients were poor surgical candidates due to serious medical problems in addition to their occlusions. Intra-arterial fibrinolysis restored arterial flow and revealed lesions suitable for percutaneous angioplasty, making surgical intervention unnecessary. As vascular surgeons and interventionalists, the authors believe that thrombolysis is underutilized in patients with lysable occlusions.
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