RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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Treatment of acute embolic and thrombotic occlusions of arteries has to be initiated immediately to save the limb at risk. Surgery has been the treatment of choice for the last decades. Percutaneous mechanical methods for thrombectomy and thrombolysis have evolved and offer alternative treatment options, reducing the peri-operative risk. ⋯ Complete removal of the clot can be achieved in 19-49%; adjunctive use of other percutaneous methods (thrombolysis and thrombectomy: 60-80%; PTA and atherectomy: 81-100%) results in primary success rates of 67-100% for recanalization of acutely occluded vessels. Primary indications for percutaneous thrombectomy and mechanical thrombolysis are acute occlusions of peripheral arteries and dialysis fistulas; limited experience exists for the treatment of occlusions of the visceral and pelvic vessels. Percutaneous methods seem promising for treatment of acute pulmonary embolism.