| Original language | English |
|---|---|
| Title of host publication | Comprehensive Vascular and Endovascular Surgery |
| Subtitle of host publication | Second Edition |
| Publisher | Elsevier |
| Pages | 262-277 |
| Number of pages | 16 |
| ISBN (Electronic) | 9780323074766 |
| ISBN (Print) | 9780323057264 |
| DOIs | |
| Publication status | Published - 21 Aug 2009 |
| Externally published | Yes |
Bibliographical note
Funding Information:The first study of thrombolysis versus surgery, the Rochester series, compared urokinase to primary operation in 114 patients presenting with what has subsequently been called hyperacute ischemia. ). By contrast, the rate of limb salvage was identical at 80%. A closer inspection of the raw data revealed that the defining variable for mortality differences was the development of perioperative cardiopulmonary complications. The rate of long-term mortality was high when such complications occurred but was relatively low when they did not. That such complications occurred more commonly in patients taken directly to the operating theater was the only explanation for the greater long-term mortality rate in the operative group. 52 Enrolled patients in this trial all had severely threatened limbs (Rutherford class IIB) with a mean symptom duration of approximately 2 days. This was a single-center trial funded by the Thrombolysis and Thrombosis Program Project National Institutes of Health grant at the University of Rochester, Rochester, New York. After 12 months of follow-up, 84% of patients randomized to urokinase were alive, compared to only 58% of patients randomized to primary operation ( Figure 14-13