Case Report: Catheter Directed Thrombolysis in Acute Limb Ischemia (ALI).


  • Khurshid Ali Punjab Institute of Cardiology, Lahore
  • Ahmad Noeman Punjab Institute of Cardiology, Lahore


Acute limb ischemia, peripheral arterial disease, thromboembolism, thrombolysis, thrombectomy, streptokinase, alteplase


ABSTRACT: Acute limb ischemia (ALI) is one of the most treatable and dangerous presentations of peripheral arterial disease (PAD). We present a case of 63 years old diabetic male with previous history of CABG 8 years ago, now presented with recent onset left lower limb pain. The limb was ischemic on examination, Doppler ultrasound showed absent arterial flow at the level of left popliteal artery confirmed with the CT angiogram. Invasive angiogram was performed followed by catheter based thrombolysis using streptokinase for 24 hours. A repeat check injection revealed resolution of thrombus and establishment of good flow in the popliteal artery and anterior tibial artery, however the distal posterior tibial artery was still occluded. The flow to the planter arch and digital vessels was well established via anterior tibial artery and its branches. The patient’s ischemic symptoms were resolved and had a patent dorsalis pedis artery at two weeks follow up and no signs of limb ischemia at rest and at moderate physical activity.

KEYWORDS: Acute limb ischemia, peripheral arterial disease, thromboembolism, thrombolysis,  thrombectomy, streptokinase, alteplase

Author Biographies

Khurshid Ali, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Ahmad Noeman, Punjab Institute of Cardiology, Lahore

Professor of Cardiology


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Case Report